HRC/VMN Speakers Bureau Request Form

Please note: If you don’t hear from us in a few days, send an email to maryjoobryan@gmail.com (sometimes this form acts up)

Your Organization's Name *

Name *

First

Last

Email *

Email

Confirm Email

Contact Person's Phone *

Date You Need a Speaker *

Program Start Time

Program End Time

Title of Presentation You are Requesting *

Approximately how many people do you expect to attend this program? Minimum participation 10-15, please market your event and provide us with a link (if public) so we can market it too *

Will your event be held in-person, a virtual online event, or hybrid? *

• This will be an in-person event at a physical location
• This will be a Zoom presentation. Requesting organization must have a Zoom account
• This will be a hybrid event (in person and Zoom presentation)
• We plan on an in-person meeting but will switch to a virtual event if necessary

Audiovisual Equipment: Speaker brings a USB drive with the presentation and/or can email it ahead of time. We are plug and play and do not bring our own equipment nor will we be able to troubleshoot or set up yours. The requestor is responsible for a laptop, projection capability, power source, microphone (if necessary), WIFI connection, remote or (someone that can advance the slides). If ZOOM is requested: setting up ZOOM links and monitoring ZOOM for guest entry, connectivity, and any guest questions in the chat. *

• Checking this box verifies that you have the capability to host the presenter

Venue Name *

If In-Person, Is the Venue Indoor or Outdoor? *

• This is an indoor venue
• This is an outdoor venue

Venue Street Address *

Venue City *

Venue State *

Venue Zip *

Submit