Request Form

Monday, 06. 29. 2009

Speakers Bureau Requests

Please fill out this form as completely as possible. We have a number of speakers available to meet your needs. If you have a particular need, please use the “Background of Speakers” box below, please let us know the kind of speakers you would like to have represented (e.g., FTM, MTF, people of color, genderqueer, crossdressers, intersex, youth, SOFFA, religious background, experience with addition issues such as domestic violence, HIV/AIDS, rural organizing, urban organizing, etc.)

Requestor Name
Requestor Email
Phone Number
Event Title
Event Description
Event Date
Event Time
Event Location
Number of Expected Attendees
Number of Speakers Requested
Background of Speakers (optional)

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Each time a person stands up for an ideal, or acts to improve the lot of others, or strikes out against injustice, he sends forth a tiny ripple of hope. That ripple builds others. Those ripples—crossing each other from a million different centers of energy—build a current that can sweep down the mightiest walls of oppression and injustice.
–Senator Robert F. Kennedy, 1966

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