Request a Speaker

Please tell us about the speaker you would like to arrange for your next event, and we will contact you within 48 hours. (*indicates a required field)

Organization*:

Date*:

Location*:

Time*:

Topic requested*: (CTRL click for multiple selections)

Speaker requested (Hold CTRL for multiple selections):

Organization Contact Person*:

Contact phone*:

Contact email:

Number of expected attendees*:

Age, gender, race or ethnicity of group if relevant:

Length of presentation*:

AV availability (laptop, projector, screen, speakers):

Newsletter items needed (speaker CV or bio, portrait):

Can we bring handouts from Summa?
 yes no

Is there anyone else speaking at this event?
 yes no

Additional Information:

Enter this code in the box below:captcha

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