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Speaker Request for Louisville Showing Up for Racial Justice (LSURJ)
Please use this form if you are requesting a member of LSURJ to assist you/your organization as a speaker, facilitator, or event sponsor.
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Your Name
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Your answer
Your Group/Organization/Company's Name (if applicable)
Your answer
Email
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Your answer
Address
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Your answer
Phone number
Your answer
Please describe your request.
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Your answer
Date of Event/Engagement
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DD
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What is your deadline for this request? (When do you need/want to have a response by?)
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MM
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DD
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YYYY
Please select one:
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This is a virtual event
This is an in-person event outdoors
This is an in-person event indoors
Not applicable - this is not an event
What are the demographics of your audience? For example, LSURJ's work is to organize white people in antiracism work, and many of our events have multiracial audiences.
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Your answer
Can you offer an honorarium/donation to LSURJ or a BIPOC-led accountability partner of LSURJ's? If so, how much? (LSURJ will follow up to coordinate.)
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Your answer
Is there anything else you need LSURJ to know?
Your answer
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