Speaker Request Form

The Oregon Center for Public Policy has speakers available to present at your organization's meetings and conferences.

To request a speaker for your organization, church, school, or workplace, please complete the Speaker Request Form below.

Thank you for your interest in our work. We will contact you as soon as possible, though it may take up to 7-10 days for a response to your request.

Contact Information

First Name*

Last Name*

Organization Name*

Organization Address

City

State

Zip Code

Daytime Phone Number*

E-Mail Address*

Confirm E-Mail Address*

Fax Number

Event Information

Date of Event (mm/dd/yyyy)

Alternative Dates

Time of Event

Event Format*

Event Topic*

Location Address

Location City

Location State

Location Zip

Expected Audience Size

Could your organization offer to pay for or help pay for:

Lodging

Travel Expenses

Meals

Other: cost of handouts, materials, etc.

Could your organization provide an honorarium?*

Yes

Other information about the event that we might like to know:

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Speaker Request Form

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