2026 - Cleveland VOTES Engagement, Event + Speaker Request Form

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2026 - Cleveland VOTES Engagement, Event + Speaker Request Form

Would you like invite Cleveland VOTES to your event as speakers, moderators, panelists or to table? Fill out the form below!

Complete the questions below to help us learn more about your event. Please submit this form at least 2 weeks prior to your event. We review new requests weekly and will follow up within 5-7 business days of receipt of this completed form. If you have any questions, please email us info@clevotes.com.

Email *

Organization Name *

Organization's Street Address (City + Zip Code)
*

What type of organization is this?
*

Advocacy or Organizing Based Organization

Business or Corporation

Government Agencies & Departments

College or University

Community Agency (Nonprofit, Neighborhood Group, etc.)

Faith Group (Congregations, Other Faith Spaces etc.)

Healthcare or Based Organization

PreK-12 Education (Schools, Educators, Student Groups etc.)

Name ( First + Last) *

Email *

Phone Number *

Will you be the primary contact for this event? *

Yes

If no, please provide the name and email for the primary contact

Service Requested - please check all that apply *

Event Attendance

Event Co-Sponsorship

Keynote Speaker

Panelist

Tabling

Training

Other:

Required

If the type of request is not listed above, please detail that here or mark N/A *

Request Description. Please also detail your goal/purpose, as well as if there are any specific calls to action you want us to lift up. *

Event Date *

YYYY

Event Time *

Time

If the event requires set up, please detail what time you'd like us to arrive *

Event Location; if virtual please provide the platform that will be used (Microsoft Teams, WebEx, Zoom etc) *

Estimated group/audience size *

Type of Event *

In Person

Virtual

Hybrid

Marketing Materials (please provide a link or email them to media@clevotes.com)

If the dates do not align with Cleveland VOTES availability, would you like us to share with values-aligned partners?

Note: We will contact you with suggestions before connecting.

Yes

Clear selection

Are there access needs of which the trainer should be aware? (i.e. ESL, audio or visual needs, etc.) If yes, please let us know what those needs are and how we might meet them.
*

Any additional information?

A copy of your responses will be emailed to the address you provided.

Submit

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