FRRC Speaker Request
Please fill out this form to request an FRRC representative to speak at your next event. After receiving your request form, we will review it and determine the best speaker for your event.
Sign in to Google to save your progress. Learn more
Organization / Company:   *
Tell us more about your organization.
We would like to know more about your organization whether it is your mission statement or link to your organizations info page.
Date of event *
Name of Event *
Start and End time of the event (include time zone) *
Event Description (please include the narrative and objective) *
How will the speaker participate? *
{IF answered Panelist above} How many people expected on the Panel?
How much time will the speaker have? *
What information would you like presented at your event? *
If Desmond Meade is unavailable, are you open to having a representative of the organization speak? *
Expected number of attendees
Audience Demographic *
Will there be media present? *
Clear form
Never submit passwords through Google Forms.
This form was created inside of Florida Rights Restoration Coalition. Report Abuse