Speaker Request Form

Speaker Request Form

Please fill out this form in order to request a meeting with Combatants for Peace activists. In the meeting there will be both an Israeli and a Palestinian speaker who will share about the movement, their own personal stories of transformation and answer any questions from the group.
Group Name*
Contact Person's Name*
Contact Person's Phone Number*
Email*
Estimated Number of Participants
Type of Group (e.g. university students, synagogue, public event)
Desired Date of the Meeting

MonthDayYear
Date
Desired Time of the Meeting

Hour Minutes

AM/PM Option
Is the date and time flexible?

YesNo
Location of the Meeting
Anything you would like to add?
How did you hear about Combatants for Peace?

Internet searchSocial mediaWord of mouth / friendsPrevious speaking eventI've been involved with the movement in the pastOther
Should be Empty: