Speaker Request Form
Please share as much information as possible to help us serve your needs. We will consider requests made at least 4 weeks in advance. If your event is sooner, please either consider a later date or consult the resources made available to you on the UP website.

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Email *
First Name *
Last Name *
Organization Name
Organization Type *
Phone number
Zipcode *
Is this speaker invited via video or in-person? (choose the most likely scenario) *
Which film(s) would you like to screen (check all that apply) *
Have you completed your purchase or booking of the film? *
Have you or your organization organized a successful film screening previously? *
Do you know which speaker(s) you would like to join you? (You may check multiple people)
Ideal date for speaker to attend your screening (present - 2023) *
~if unsure, provide your best estimate~
Ideal time for speaker to attend your screening (please include start and end time) *
~if unsure, provide your best estimate~
Any additional info about ideal date? (i.e. is your date firm or flexible?)
Estimated Audience Size
Clear selection
Do you have a budget to provide honoraria for speakers? Please share as many details as possible. *
Are you working with any partner organizations you would like to mention? (please list names)
Anything else you want us to know about your screening plans?
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