Speaker Request Form

Use this form to submit a request for a member of the Finney Media Team to speak at your event or organization.

Event Overview
Contact Person:*
Enter your name
Organization:
Enter the name of your organization
Phone Number:
Enter your phone number
Email Address:*
Enter your email address
Event Details
Event Date:*
Enter the date of your event
Event Location: (city/state/venue)*
Enter the event location
What is the purpose of this event?*
Please provide a brief description of the event.
Presentation Details
Topic of Presentation:*
Length of Requested Presentation:*
Enter how long you want someone to speak
Powerpoint Requested?*
- Yes
- No
Will there be Wifi Access?*
- Yes
- No
Will there be a Q&A?*
- Yes
- No
Audience and Key Participants:*
Audience Size:*
Additional Details?
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