Speakers Bureau Request

To assist you and your organization with a department specialist in any of the listed areas, please fill out this form.

If you are submitting a request for more than one topic, please take the time to fill out a form for EACH topic.

(Please submit your Speakers Bureau Request forms at least 3 weeks in advance.)

* indicates a required field

Please provide the following personal contact information:

Name *

Title

Organization

Phone Number *

Cell Phone Number

Email *

Please provide the following group or organization contact information

Name of Organization or Group

Organization phone number

Organization Email

Organization URL

Speakers Event Details

Enter the date this presentation would occur: mm/dd/yyyy *

Enter the time this presentation would occur: *

Please provide detailed directions and the address of the location this presentation would take place. *

Please describe in detail the subject that you would like the speaker to address and how it relates to your organization. *

Please tell us about your organization, its goals, and describe the audience who will hear this presentation. *

Please list any audio visual aids that may be provided for the speaker. (LCD, Computer, Microphone, Podium)

Please provide an alternate point of contact for presentation (not requester).

Name

Title

Organization

Work Phone

Cell Phone

How did you hear about the Boise Police Speakers Bureau? *

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