Speaking Request Form

Roland S. Martin and Dr. Jacquie Hood Martin are available for speaking engagements throughout 2025 and 2026. Take this opportunity to hear two of America’s most prominent voices. 

If you would like to schedule Roland S. Martin or Dr. Jacquie Hood Martin as a speaker at your next conference or event please fill out the form below.

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Speaker you are interested in booking *
Primary  Contact's Name *
Primary Contact's Email Address *
Primary Contact's Phone Number
Primary Contact's Mobile Phone
Secondary Contact's Name *
Secondary Contact's Email Address *
Secondary Contact's  Phone Number
Secondary Contact's Mobile Phone
Name of Organization/Company
Organization Website
Organization Type *
Organization Industry *
If other
Additional Organization Details
Role in Event
Prospective Date of Event -- First Choice
 *
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Second Choice Date
 *
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Keynote Topic
Event Start Time (approximate) *
Time
:
Start Time of Speaker *
End Time of Speaker *
Event Name *
Event Description *
(name of the event, length of speech, attire for event, format, topic, luncheon, dinner, reception or theater style seating) DO NOT INSERT PRESS RELEASE
Panel Topic *
Panelists: Specific Names and Affiliation
Venue Name
Venue Address *
Please enter the full address of the venue in the following format:
Street
City, State Zip Code
Country
Closest Airport To Venue *
Audience *
What media outlets (radio, television, newspaper) will be present at this event?
How is the event being promoted?

Organization Will Cover Expenses

Expenses Covered By Organization

Speaker will have products (book, tapes, etc.) available for your event. Would you be willing to provide 2-3 people to help sell Speaker’s products?
Honorarium *
Speaker will have products (book, tapes, etc.) available for your event. Would you be willing to provide 2-3 people to help sell Speaker’s products?
Clear selection
Deadline for Response *
MM
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Submit
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