Speaker Request Form

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Name of IS staff member invited to speak*
Is the host organization an Independent Sector member?*
Host organization point of contact name*
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MM slash DD slash YYYY
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What is the format of the event/opportunity?*
Event/opportunity location address (for in-person opportunities)*
Communications contact for the event/opportunity
MM slash DD slash YYYY
Helpful examples include: nonprofit leaders, general nonprofit sector audience, philanthropy, business group, racial justice, youth focused, housing, state association, etc.
Please be as specific as possible.
Please offer names, titles, orgs, areas of expertise, etc.

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