Speaker presenting to a group. Photo credit: CBF Staff.

Speakers Bureau Visit Request

Please complete the form below, and a staff member will be in touch to confirm the availability of a speaker. We require at least 10 attendees for events, and prefer 4-6 weeks advance notice for requests.

Program not available in Maryland.

*

Question - Required - Name of Group

Contact Information


*	First Name: Required
*	Last Name: Required
*	Email: Required
*	Phone Number: Required
	Your submission includes periodic e-mail updates from CBF. You may unsubscribe at any time by clicking "Unsubscribe" at the bottom of any e-mail you receive from us.

Question - Not Required - Are you a CBF member?

Logistics

Question - Not Required - Preferred Date

Month

Day

Year

Question - Not Required - Start/End Time for Event

Question - Not Required - Deadline for Booking

Question - Not Required - Meeting Location - Street

Question - Not Required - Meeting Location - City

Question - Not Required - Meeting Location - State (not available in Maryland)

Question - Not Required - Meeting location - Zip

Audience Information

Question - Not Required - Number of expected attendees

Question - Not Required - Requested Topic

(Maximum response 255 chars, approx. 5 rows of text)

Question - Not Required - Presentation Length

A/V Resources

Question - Not Required - Do you have:

	Projector Screen (or white wall that can be projected on)
	Projector
	Laptop
	Podium
	Power Source
	Extension Cord
	Microphone