VOA Utah Speaker, Presentation, Media Request
Our staff and volunteers are happy to share our experience, expertise, and stories with the community. 

Please complete this form, preferably 15 days prior to your requested presentation, or 30 days prior for speakers with clinical/specialized backgrounds.

Speakers are available weekdays between 8 am to 7 pm. (Note: tours of the Youth Resource Center require participants to be age 16 or older.)

Questions? Contact us at dan@voaut.org

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Email *
Event Overview
Contact Name *
Contact Phone Number *
Name of Organization Hosting Event *
Description of Organization: *
Event Title: *
What is the purpose of this event? *
Event Location (City/State/Venue/Room) *
Reminder: If you are requesting a speaker with a clinical or specialized background (for example, a clinician to speak about substance abuse treatment, etc.), we will make every effort to accommodate this, but we do ask for a minimum of 30 days' notice. We may be unable to accommodate requests for clinician speakers without sufficient notice for scheduling. We require 15 days' notice for other requests. 
Event Date (Minimum 15 days from today) *
Is this a personal residence or a business? *
Event Start Time *
Event End Time *
VOAUT Representative Requested Start Time *
VOAUT Representative Requested End Time *
Audience Type *
Estimated Audience Size *
Type of Presentation (panel discussion, open remarks, ride-along, etc.) *
If panel discussion, or other speakers attending event, please provide a list of other invited and/or confirmed panelists/speakers: *
Topic of Presentation *
Presentation Overview
What do you hope to achieve from this presentation? *
Area of Interest (Check all that Apply) *
Please identify any particular speakers from Volunteers of America, Utah requested for this event:
Will there be a Q&A? *
Expected Media Coverage *
Will this event be recorded?
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Is this event appropriate for soliciting donations from attendees? *
If a VOAUT representative is unavailable to attend in person, would a pre-recorded message or video be an option? If yes, please state preference. *
AV Equipment Available/Provided (please check all that apply) *
Would you like our representative to bring any promotional or marketing materials? If yes, please check all that apply: *
Additional details/notes
Want to stay in the loop with us via email? *
A copy of your responses will be emailed to the address you provided.
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