Host Application
For Community Groups, Schools, Universities
Name of Organization/Institution
Address for Speakers Bureau Event
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Contact Name
First Name
Last Name
Contact Email
example@example.com
Contact Phone Number
Please enter a valid phone number.
Audience
Elementary Aged Students
Middle School Aged Students
High School Aged Students
University/Law Students
Adult
Senior Citizens
Date and Time of your Event
What would you like the speaker to discuss?
Length of Program
Event Type
Conference, panel discussion, training session, school presentation, etc.
Would you like the Lancaster Law Foundation to share your event to publicly promote it?
Yes
No
Other
Additional Event Details
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