Stonewall Speakers - Engagement Request Form for Middle and High Schools

Connecticut Stonewall Speakers is a non-profit 501(c)3 organization comprised solely of volunteers. We request an engagement fee of $200 for our panel presentation. If you have the funds to afford more than the minimum, your kindness in doing so is deeply appreciated. Any monetary contribution toward our expenses, however small the amount, is gratefully accepted.

Please make out checks to: CT Stonewall Foundation, Inc., and mail to: 121 Shield Street, PO Box 331091, West Hartford, CT 06133

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Email *
Phone Number *
Contact First Name *
Contact Last Name *
Name of School *
Address of School *
Type of Engagement Requested *
Dates Requested *
Times Requested *
Class/Subject Area *
Estimated Number of Students/Audience Members *
Parking Information/Directions to School
Speaker Preference
If you have a preference for how speakers identify (Gay, Lesbian, Bisexual / Pansexual / Queer, Transgender, Ally, Asexual, Intersex) please let us know and we will do our best to accommodate
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