Speaker Request Form
Email *
Full Name of Person Requesting *
Phone # of Person Requesting *
Your Organization's Name *
Anticipated Event Date *
Anticipated Event Name *
Brief Description of the Event *
Anticipated Event Start Time *
Anticipated Event End Time *
When within this event will the presenter be speaking and how much time will they be given? *
What type of presenter are you requesting? *
If "Other" is selected, please describe.
Why are you interested in VBJI and in the topic of human trafficking for this group? *
How did you hear about our organization? Who or what caused you to reach out to us for this event? *
How many people will be at this event? *
Describe the audience for this presentation (age, gender, expectations) *
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