Request a Speaker
Please complete the form below to request a Xerces Society presentation at your event. Xerces will review your request and contact you within 2-4 weeks.

**Since we receive many requests for speakers, please understand that we are only able to participate in a limited number of events.
**We are unable to accept tabling invitations.
**We typically need at least three months advance notice for new requests.

Contact Name *
Your answer
Email Address *
Your answer
Phone Number *
Your answer
Event Name *
Your answer
Group hosting the event *
What organization or agency do you represent?
Your answer
Event Date *
If a date is not scheduled for the event, please note the expected month and/or time of year the event will take place.
MM
/
DD
/
YYYY
Event Time *
If a time is not scheduled for the event, please note the approximate time of day the event will take place
Time
:
Event Duration *
Please give us an approximate length of time for the event
Hrs
:
Min
:
Sec
Event Location (city, state) *
Your answer
Topic *
Please select all that apply
Required
Description of talk
Please describe the desired presentation topic in greater detail
Your answer
Length of Talk *
The Xerces Society can provide presentations from an hour in length to a full day training, depending on the topic and audience.
Who is your audience for this event? *
i.e., farmers, agricultural support staff, gardeners, land managers, students, general public, etc
Your answer
How many people do you expect will attend the presentation? *
Your answer
Do you have any funding available to help cover Xerces staff time and/or travel expenses? *
Your answer
Is there any additional information we should know about this event?
Your answer
Have you been in contact with a Xerces Society staff member about this event? *
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service