Request a Speaker

Use this form to request a speaker from Minnesota Family Council & Institute for your event.

Name

First Name

Last Name

Email Address

Group Name or Affiliation

Reason for Requesting Speaker

Phone Number

Event Location

Please indicate the City and Zip Code of event location

Please indicate three dates you would like to host this event, in order of preference. Date 1:

Date 2:

Date 3:

Does Event Location have Technology Available for PowerPoint?

Yes

Is there an Honorarium? If so, what is the amount?

Minnesota Family Council & Institute generally requests an honorarium for speaking events to cover our transportation costs and staff time.

Will there be other presenters at this event? If so, please indicate who the other presenters are.

Will you be seeking permission to film?

Yes

Any additional information that we should know?

Any questions we can answer for you?