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*

DayMonthYear
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: