Presenter Request Form
Thank you for your interest in contributing to the African American Cultural and Historical Museum’s educational and cultural programming. This request form will help us understand the focus of your presentation, your background, and how your session aligns with our mission to honor, preserve, and amplify African American history and culture. We look forward to the possibility of collaborating with you to engage and inspire an  audience.
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Email *
Name of group  *
Contact Person: First Name *
Contact Person: Last Name *
Email *
Preferred Phone Number *
By checking this box, you agree to receive text messages about Marketing, Customer care, and account notifications from the African American Cultural and Historical Museum of Washtenaw County. You may reply STOP to opt out at any time. Reply HELP for assistance. Message and data rates may apply. Message frequency will vary. This is our Privacy Policy & Terms and Conditions *
Please briefly describe your program (e.g., dinner, conference, retreat, etc.). *
What is your budget? *
Would you like a speaker, workshop, or presentation? *
Required
Would you like a speaker, workshop, or presentation? *
Required
Zoom or In Person?  *
Topic for the Speaker/Presentation/workshop  *
Speaker/Presentation/Workshop Duration  *
Required
Audience  *
Required
Describe audience background *
Required
Total Number of Participants *
Resources/Tech Support *
Required
Technology Provided
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Requested Date #1 *
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Requested Date #2
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Requested Date #3
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