On the Margins Speaker Request Form
On the Margins strives to hold meetings, conferences, and other professional events where all attendees feel welcome and barriers of any type do not exclude people from attending or participating. We recognize that long-term and lasting progress on this front will require time, sustained effort, and the cumulative impact of incremental and individual actions. Please complete the form below to request a presentation or workshop.
Name
First Name
Last Name
E-mail
example@example.com
Phone Number
Organizational Affiliation
Is the event venue online or in-person?
What is the event duration (e.g., 1 hour)?
What are the suggested dates for your event?
Dates when you would like the event to take place.
Are these dates flexible?
What is the start and end time of the event?
Will you charge a fee to attend your event ?
How many are expected to attend your event?
What is the topic you would like for us to present on?
Are there any accomodations we should be aware of?
Do you currently have a budget to compensate the presenter(s)? If so, what is your existing budget?
If in person, check the items that will be available for the presenter:
Laptop
LCD Projector
White Screen or smart board
Microphone with speaker system
Clicker or slide advancer
N/A
Other
Where will the presentation take place?
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Submit
Should be Empty: