Speaker Request Form
Speaking engagements typically last one hour with a fifteen minute question and answer period encouraged.

Before requesting a speaker, download the Guideline For a Holocaust Survivor visit (www.holocauststudies.org/files/guidelines-for-a-holocaust-survivor-visit.pdf)

Schools must provide safe and clean round trip transportation for speakers as well as a $200 honorarium to the Museum.
Name *
School/Organization *
Address *
City *
State *
Zip Code *
Email *
Phone # *
Date and Time
Please note: Speakers are available between 10:00 am and 3:00 pm. Special arrangements can sometimes be accommodated.
Date of Visit (1st choice) *
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Time
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Date of Visit (2nd choice) *
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Time
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Date of Visit (3rd choice) *
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Time
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If a teacher, for what grade and subject are you an instructor?
How will this talk benefit your school/organization? *
What is the projected number of listeners attending?
Submit
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