Speakers Bureau

To request a speaker from the Tri-Faith Initiative, please complete the form below at least 30 days before your event. Our speakers are volunteers, so we cannot guarantee a speaker for every event, but we will do our best to fulfill your request. Thank you for your interest!

Name of Organization:

Name of Event:

Date & Time of Event:

Location of Event With Address:

Name of Contact Person:

Email: Cell Phone:

Mission of Organization:

Topic(s) to be addressed by guest speaker:

Are you requesting more than one speaker? If so, please explain:

Desired length of guest’s speech: # of Attendees Expected:

Describe the format and schedule of the event:
(e.g., panel, lecture, workshop, interview, keynote, etc.)

Who is the target audience?

Is the event free to attend? (Check one) YesNo

Do you have a computer or projector available for DVD
or PowerPoint presentation?YesNo

List any event sponsors or partners:

List any other invited speakers:

Will travel expenses be reimbursed? (Check one) YesNo

Will media be invited to this event? (Check one) YesNo

Will this event be recorded or broadcast? (Check one) YesNo

If ‘Yes’, please explain:
Specify event attire/dress:(Check one) CasualBusinessBlack Tie

Would you like a photo and/or bio of the speaker(s)
for promotional purposes?(Check one) PhotoBioBoth

If so, please select your preferred format: JPGPDFDOCOther:

Please provide additional pertinent information about your event:
(i.e., website URL, event program, promotional materials, etc.)*