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GIP Speaker Request Form
Please fill out this form to request a Georgia Innocence Project staff or exoneree speaker for your event.
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* Required
Name of group or institution
*
Your answer
Website of group or institution
*
Your answer
Your name
*
Your answer
Your title
*
Your answer
Your email address
*
Your answer
Your phone number
Optional
Your answer
Location of speaking engagement
*
Virtual
Other:
Date and time of speaking engagement
*
If you are considering a number of possible dates and haven’t chosen one yet, please include all possible dates
Your answer
Format and length of speaking engagement
For example, indicate whether it’s a single speaker format or a panel, and indicate if you have a preference for how much of the time will be spent on presentation and how much on questions and answers.
Your answer
What kind of speaker would you like?
*
Client Services Staff
Outreach Staff
Legal Staff
Exoneree
Other:
Please provide any other relevant details as it pertains to your request
*
For example, theme of conference, willingness to provide honorarium, etc.
Your answer
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