Personal Information
Please submit your speaker request 4-6 weeks in advance of your event. Unfortunately, we cannot guarantee a speaker for requests submitted less than one month in advance. Thank you for understanding!
Your Name
*
Email Address
*
Phone Number
*
Website
Event Information
Tell us about your event!
Date of Your Event
*
-
Month
-
Day
Year
Date
Event Start and End Time
*
Length of Speaking Time
*
Location of Event
*
Please include the address
Estimated Number of Attendees
*
Brief Description and Focus of Event
*
Can we share about this event on social media?
*
Please Select
Yes
No
Let me check on that
We love to share about how we partner with the community to raise awareness!
Is your event open to the public?
*
Please Select
Yes
No
TBD
Does your event include time/space for a table set-up?
*
Please Select
Yes
No
Let me check on that
Are you able to reimburse the speaker for travel expenses and/or provide an honorarium?
*
Please Select
Yes
No
Let me check on that
Special Considerations
i.e. Hearing impairment, literacy levels, trauma history, etc.
Are you able to provide the necessary equipment and technology for a PowerPoint presentation and videos?
i.e. Projector, Screen/TV, HDMI cord, WIFI, Mic, Speakers, etc.
What topic(s) would you like to be covered in the presentation?
Human trafficking statistics and awareness
How to identify and report trafficking
Prevention for youth
The Lampstand mission and services
Opportunities to get involved with The Lampstand
Other
Who is the audience?
*
Elementary Students
Middle School Students
High School Students
College Students
Business
Church
Philanthropic/Community Organization
Parents
General Public
Medical Professionals
Youth-Serving Organization
Law Enforcement
Social Services
Other
Is there anything else you would like us to know?
Submit
Should be Empty: