Local Speakers' Bureau Event Request Form
Thank you for your interest in having the “Faces of Homelessness” Speakers' Bureau attend your upcoming event. This public education program is an essential part of our mission at the National Coalition for the Homeless, and we appreciate you giving us this opportunity.

We promote advocacy, education, and service. As people who have been homeless or are experiencing homelessness, the speakers in the Bureau are the real experts on homeless issues and we believe that their voices are essential in the fight to end homelessness. Speakers' presentations work to promote advocacy, understanding and service.

We look forward to working with you and learning more about your event. Please review our information and guidelines for event hosts and complete the event form and return it in a timely manner.

Email address
Event Guidelines and Information
Presentation Format : Groups requesting one speaker should allot 30 - 60 minutes for the presentation to include introduction, moderation, video (if requested-see below recommendations), speaker, Q & A, and informal interaction with the speaker post-session.

Groups requesting two or three speakers should allot 60 - 90 minutes for the presentation to include introduction, moderation, video, speaker(s), Q & A, and informal interaction with the speakers' post-session.

These time frames are only recommendations. The Speakers' Bureau has worked with a variety of faith groups, student organizations and social action service-oriented groups with presentations ranging from full high school assemblies to smaller panel presentations. We can be flexible and can adjust our presentation format to fit your group's schedule.

Video suggestions:

National Coalition for the Homeless
Hard times generation: homeless kids
Hard Times Generation: Families living in cars

Honoraria : Each speaker will receive a suggested $50 honorarium each time they speak locally in the DC metro area.

Program Fee : We ask that groups provide a program fee to the National Coalition for the Homeless of 50% of total honoraria to bring the “Faces of Homelessness Speakers' Bureau to your group. If you are unable to provide 50%, please let us know.

Total Costs :

For 1 speaker -- $50 honorarium plus a $25 program fee. Total: $75
For 2 speakers -- $100 honoraria plus a $50 program fee. Total: $150
For 3 speakers -- $150 honoraria plus a $75 program fee. Total: $225

Payment : NCH will send an invoice via email to your group once the request form is received and event is scheduled. We ask that you pay upon receipt of the invoice, in advance of the speaking engagement. Payment via check is preferred, but we also accept cash or credit card charge via our website.

Travel : If you are located in the DC metro area we can usually use public transportation or a cab.

Become a Member/Make a Donation : If your organization would like to support the work of the National Coalition for the Homeless, it can do so by becoming a member or by making a donation. More can be found on the NCH website (www.nationalhomeless.org).

What is the name of your organization?
Your answer
Primary Contact Information: Name/Title
Your answer
Email Address
Your answer
Mailing Address
Your answer
City/State/Zip Code
Your answer
How many speakers would you like on the panel (recommended: 2-3 speakers)?
Your answer
Would you like to request a particular speaker or have other specific requests (gender, etc.)?
Your answer
What date is your event?
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What time would you like speakers to arrive?
Time
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Where is your event located?
Your answer
How long do you expect your event to last?
Your answer
Will food be provided before or after the event?
What is the best way to get to the location of the event (if public transportation, please indicate which subway line/stop or bus number and stop. If the venue offers a free shuttle, please give the appropriate logistical information, e.g. pick-up time)?
Your answer
What is the format of the event (keynote, workshop, class, discussion, etc.)?
Your answer
Please list the cell phone number of a contact who will be attending the event.
Your answer
Do you have a particular subject focus or audience need (homeless children, housing issues, health care, policy, etc.)?
Your answer
What is your expected attendance?
Your answer
What is your audience's age range?
Your answer
What is your audience's level of knowledge on homelessness?
Your answer
Would you like to sponsor a Faces of Homelessness panel for a school or organization that cannot otherwise afford to bring speakers to educate their young people?
If yes, how many speakers would you like to sponsor (the total cost will be added to your invoice)?
Your answer
Other comments/questions?
Your answer
NCH/Group Agreement
All honoraria ($50 for each speaker) and the program fee (50% of the total honoraria) must be included in one check made out to the National Coalition for the Homeless in c/o Speakers' Bureau. See the first section entitled, Event Guidelines and Information, for a cost breakdown.

Please fill in the check memo section with: Speakers' Bureau (date of presentation).

If you are unable to provide the 50% program fee cost, please let us know and we can discuss possible arrangements.

Once we have received this filled out Event Info Form, we will send you a confirmation within 72 hours of receiving the request. We will also send you an invoice in advance of the event.

The Following organization agrees to pay the National Coalition for the Homeless for honoraria and program fee:
Your answer
Payment should be mailed in advance of the presentation or mailed on the day of the event. The undersigned agrees to reimburse NCH within 30 days of receiving the invoice. By entering your name in the field below, you are effectively providing your signature, indicating your consent to abide by the terms of this agreement.
Name
Your answer
Date
MM
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YYYY
A copy of your responses will be emailed to the address you provided.
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