External Speaker Requests for CAR Leadership

Your Name*

First Last

Your Organization*

Your Phone*

Your Email*

Event name*

Event host*

Event type*

Who are you requesting to speak:*

If other, please indicate who:

Please select one if you are requesting a diversity, equity and inclusion advisor for your organization*

If yes, briefly advise any topics you would like covered

Date of presentation*

Time of presentation*

:

Time zone*

Event location*

Length of presentation*

Audience size*

Tell us about your audience*

Requested topic*

Please summarize to the best of your availability.

Visual needs – will a screen be available to share a powerpoint?*

Will this presentation be made via webinar?*

Any additional instructions/requests please provide below:*

CAPTCHA