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 *
Cell Phone Number *
Please briefly describe your program (e.g., dinner, conference, retreat, etc.). *
Would you like a speaker, workshop, or presentation? *
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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