Polaris Speaker Request Form

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Speaker Fees
Polaris is a non-profit organization that strives to balance promotion of the movement with sustainable funding for our mission. Polaris welcomes the opportunity to discuss a Speaker’s Fee or Honorarium in support of your event. Importantly, Polaris will never expect a fee or honorarium from another NGO in the anti-trafficking movement for our participation.

Email *

Requester Name (First, Last) *

Event Name *

Host Organization *

Event Type *

Is there an option for virtual participation? *

Yes

Speaker Requested Date & Time *

YYYY

Time

Presentation Length (hours, minutes) *

Location (City, State) & Venue *

Event Start & End Dates

Anticipated Audience Size for Polaris Presentation *

Audience Composition & Description *

Presentation Topic

What specific topic(s) do you want Polaris staff to present on? (e.g. broad overview of trafficking, trafficking of LGBTQIA youth, etc.)

Event Description *

Provide a few sentences describing the purpose, theme, goals, etc. of the event. Also include how the requested speaking engagement fits into the overall theme of the event.

Event Website

Requested Speaker (if known)

If known, please indicate specific individuals or teams you would like to speak at your event.

RSVP Required By *

When does Polaris needs to reach back out to RSVP yes or no to speaking engagement?

YYYY

Can Polaris post about this event via social media? *

Yes

Required

Additional Notes

Any other pertinent information (e.g. point of contact, connection(s) to Polaris/staff, if Polaris has engaged in this before etc.)

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