Request a Speaker

Please complete the following CHAT Speaks request form and we will contact you shortly!

Note: Speakers are provided free of charge and require one month advance notice. The hosting organization is responsible for costs and arrangements associated with the venue, room set-up and equipment. The host must also provide the speaker with a contact person for technology and logistics, as well as arrival and parking instructions.

Contact Name *
Contact Name
Contact Phone *
Contact Phone
Address *
Date Requested *
Date Requested
Preferred Speaker *