£R Speaker Interest Form

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Thank you for your generosity in sharing your expertise with Money Rebellion's audience.

We'd like to have a clear understanding of what you'd like to discuss and obtain information to promote you, your organization(s), and your work.

We ask that you please consult our Principles & Values to gain more familiarity with our audience and interpersonal dynamic.

https://extinctionrebellion.uk/the-truth/about-us/

FIRST NAME *

LAST NAME *

PHONE NUMBER

CITY *

COUNTRY *

Who invited you to join us for a talk? *

What is your title/ area of expertise? *

Please share a short bio - list any accomplishments, awards, or honors. *

What title might you suggest for your topic? *

Please describe topic in further detail. *

1. What are some key facts, perspectives, or opinions you're likely to mention? *

2. Any other key facts, perspectives, or opinions?

Proposed length of talk? (check all that apply) *

20 mins

30 mins

45 mins

1 hour

Over an hour

Required

Which length of Q&A session are you comfortable with? (check all that apply) *

15 mins

30 mins

45 mins

1 hour

Over an hour

I would not like to participate in a Q&A

Required

'Additional reading' links, if any.

Preferred method of contact *

Text

Phone

Signal

Other

First-tier

Second-tier

Third-tier

Any other preferred form of contact?

Twitter (link preferred for accuracy)

Facebook (link preferred for accuracy)

Instagram (link preferred for accuracy)

Any other social media accounts you would like us to mention?

Website(s)? Please list all you would like highlighted: personal, organizational, etc.

Any work of yours (books, papers, films, social media content, and related links) you would like us to promote?

If a speaker uses slides, our audience often requests to be shared on them after the talk. Would you be willing to share your slides? *

Yes

I will not be using slides

If you are willing to share any slides, please provide link (we will not share prior to event).

Please link any images to utilize for event marketing.

Might you be interested in future events with Extinction Rebellion? *

Mind sharing your favorite quote? (your own or another's. we just love quotes!) *

Any questions, comments, suggestions, and/or feedback?

Submit

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