Speaker Request Form

We have changed the steps for Speaker Requests. Please go here to begin.

NEW SPEAKER REQUEST FORM

[Note: The form below no longer goes to an O.U.R. team member. Please do not use this form. It will not result in you beig contacted about your event.]

Are you filling out this form at least 3 weeks in advance of the speaking engagement you are requesting*

Yes, it is 3 weeks or more before the requested date.No, it is less than 3 weeks from the event date.
We are unable to accommodate speaking engagements with less than three weeks notice at this time. Please choose a date that is atleast 3 weeks out from today.
Terms and Conditions for Speaking Events
I acknowledge and agree to the terms and conditions outlined above:*

Clear

Select from the following that best describes who you are or who you represent. Information and questions that follow will refer to you as the Host.
Who are you?*

O.U.R. Speaker self-proposing a speaking engagementStudent Club requesting a speakerIndividual/group/organization requesting an O.U.R. Speaker for an event I am hostingO.U.R. employee
Student Club Name*
Often a speaker is requested in cojunction with an event. If you are planning the event this speaker will be speaking at please click on the following link and fill out a project request.
Organization Name*
What organization is making this speaker request? Examples, name of nonprofit, name of school, name of local lions club, name of business. If you are in individual you can leave this box blank.

O.U.R. Employee
Employee Name*

First NameLast Name
Employee Email*
example@example.com
In what way can we support*

Creation of a presentation (powerpoint)Coordination with host of event
Has this event been approved by PR?

YesNo
Host Name*
Host Email*
example@example.com
Host Phone Number*
Please enter a valid phone number.
Date of event*

MonthDayYear
Date
Please give us a little background on the event. *
Let us know what you want to have in your presentation.*
We appreciate you providing as many details as you can as this helps us when creating your presentation.
Often a speaker is requested in cojunction with an event. If you are planning the event this speaker will be speaking at please make sure to also fill out a project request.
When do you need your presentation by?*

MonthDayYear
Date
How long will your presentation be? *
in minutes
Upload any specific images that you would like included in the presentation.

Cancelof

Your Contact Information
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid USA phone number. If submitting an international phone number put all 0's above and fill in international number below.
Country*

Event Date & Venue
Date of Event*

MonthDayYear
Date
Event Start Time*

Hour Minutes

AM/PM Option
Event End Time*

Hour Minutes

AM/PM Option
Specific time O.U.R. presentation will start*

Hour Minutes

AM/PM Option
Time Zone
Contact at Venue

First NameLast Name
Venue Contact Phone Number
Please enter a valid phone number.
Venue Contact Email*
example@example.com
We have speakers in various places throughout the U.S and so attempt to send speakers in person to as many events as possible. However, sometimes due to distance or number of people who will be attending the event, we are unable to send a speaker to attend in person. Fortunately we can almost always provide you with a virtual speaker. Please indicate below if your event/venue will allow you to have a speaker attend virtually.
Are you requesting an in-person or virtual presentation ?*

In-PersonVirtualIn-Person or Virtual
Event Location (If virtual, please put N/A for Street address but still include the City, State/Province, and Country)*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
When scheduling and referring to your event, we use a name to identify it internally. So we ask you to enter a name here. If you don't have an event name, make one up. Let's say you live in Lincoln City, OR and are planning an awareness event at a local community center and are inviting the general public to it. You could call it Lincoln City Community Awareness night.

In the section titled Event Description you can add more details. For example, "This will be a public event where we will invite public officials including the mayor and police chief and the community at large. We will provide tickets obtainable online but there will be no charge."
Event Name*
Event Description*
Will the venue have power-point presentation capabilities?*

YesNo
Will wifi be available?

YesNo
Please specify any technology that you can utilize at the venue:
Ex. Microphone, cables to plug in laptop (mac and/or pc), a computer at the venue they can log into etc.

Presentation Content
Please select the topics you would like discussed during the presentation (Select all that apply)*

About O.U.R. (Our history and work)What is Human Trafficking?Types of Trafficking and ExploitationGrooming & Online SafetySigns of Human TraffickingAftercareHow to Volunteer with O.U.R.
Please explain what you wanted talked about within topics you selected above and how much depth you would like them discussed
Example" I would like the presentation to include a brief overview of what O.U.R. is, spend majority of the time on what human trafficking is and the types of trafficking and a little bit of time at the end to discuss ways to get involved.
Length of Presentation*
ex: 30 minutes or between 15-20 minutes
Do you want the speaker to do any Q&A from the microphone/podium? If so, will this be part of the total presentation time or will there be additional time for this?
Note: Whenever possible speakers will stay after their presentation to answer individual questions from the audience.
Anticipated Size of Audience*
Audience Demographic*
Ex: Community Group, High School, Business, Teenagers, Church Group...etc. PLEASE INDICATE HERE IF MINORS WILL BE PRESENT.
Is this for a specific discipline?
Ex: Healthcare, Law Enforcement, Social Services, Travel, Hospitality.
Are there any other speakers also speaking at this event besides the proposed O.U.R. Speaker? Include their full name and organization affiliation. Please enter N/A if there will be no other speakers*
Please detail any other speakers that will also be taking the stage. We do not organize speaking events for other speakers, that is between you and the other speaker. Please review terms and conditions for full guidelines.

Your Speaker
Do you have a request for a speaker? (optional)
O.U.R. is unable to schedule Tim Ballard for any speaking events. Please do not request him as we are unable to grant these requests. Also, we cannot guarantee that we can accommodate requests for a specific speaker. We can guarentee we will carefully considering your wishes with our speakers and will strive for the best possible match ups.
Are you already in contact with your requested speaker?

YesNo
Operation Underground Railroad is a non-profit organization and exists entirely on donations. We hope to provide speakers for all requests but sometimes we need to make choices due to our limited budget. To assist with the probability of your request being approved we ask for help with the costs. Are you able to cover or help with your speaker's travel expenses? Please list here what you are willing to cover, flight, hotel, food, gas, specific donation amount, other.*
Ex: Flight, Hotel, Food, Gas, etc
Will a fundraiser be part of your event?*

YesNo
Pleses describe how you will be conducting your fund raiser.
Examples, Silent auction, 50% of all earnings from food truck purchases will be donated.
Anything else you would like us to know?

Volunteer Team/Student Club