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Speaker Request Form
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Event Information
Event name
Organization hosting event
Date and time of desired appearance
Location of appearance (city, state, venue)
Nature of appearance (keynote speech, debate, panel, etc.), desired subject matter, and expected duration
Will CLE credit be offered to attendees?
Yes
No
Are written materials required?
If so, by what date?
If other speakers are involved, please list those confirmed
Other potential speakers being contacted
Description of event and audience (number of attendees anticipated; are they law students, practicing attorneys, business group, etc.)
Will members of the news media be present?
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No
Will the event be videotaped or recorded?
Yes
No
Is the event open to the public?
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No
Is there an admission charge?
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No
Organizers will pay speaker's
(please check those applicable)
Local expenses
Air travel
Hotel and meals
Honorarium of
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