Promises2Kids Youth Speaker Request
Request must be made 30 days prior to speaking engagement
Contact Details
First Name
Last Name
Phone
Email
Youth Speaker Request
Date of event
Start Time
End Time
Staff member attending event
Phone of attending staff member
What time should the speaker arrive?
How many minutes does the speaker have?
Purpose of Presentation
Name of Event
Type of Event
Formal
Informal
Attire
Formal
Business
Business Casual
Other
Other Attire Description
Number of Attendees
Demographic of Attendees (Gender, Age Range, etc.)
Talking Points + Focus Area (if any)
Will there be a Q&A?
Yes
No
Not Sure
Will any of the following be provided?
Microphone
Podium
Food
Organization/Business Name
Description of Organization/Business
Street Address
Building Name/Room #
City
Zip
Speaker Preference
Gender
Male
Female
N/A
Does the youth need to be a participant (including past) of any specific program(s)?
Polinsky Children’s Center
Camp Connect
Guardian Scholars
Foster Funds
N/A
Does the youth need to be a participant of any specific subgroup?
Advocates for Change
Men’s Leadership Network
Women’s Leadership Network
Black Mentoring Group
Latinx Mentoring Group
Parenting Group
Youth2Youth
N/A
Parking
Does the location have parking onsite?
Yes
No
Not Sure
Is Parking Paid or Free?
Paid
Free
Not Sure
Parking Location Details
Other Important Details or Special Instructions
If available, please upload any relevant documents (agenda/timeline/etc.)
Contact Information