Get Speaker Request Form - National Association Of State Mental Health ...

Filling out the Speaker Request Form is an essential step in securing a speaker for your event. This guide provides clear instructions to help you navigate the form efficiently and ensure that all necessary information is provided accurately.

Follow the steps to complete your Speaker Request Form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the applicant's name, title, and organization at the top of the form. These fields help identify who is making the request.
3. Fill in the street address, city, state, and zip code of the organization to ensure accurate communication.
4. Provide a contact phone number and email address for further correspondence related to the speaker request.
5. Indicate the date of your request to establish the timeline of your inquiry.
6. Specify the name and title of your event, along with the date and location including street address, facility name, and room number, to assist in proper scheduling.
7. Describe the event theme and provide a brief overview to give context to the request.
8. Indicate whether the event is at the national, state, regional, or local level to inform the scope of the request.
9. Select the type of speaking session you are requesting: keynote, plenary, or breakout session, and specify the number of each category.
10. Detail the date and time of the speaker's presentation along with the expected length of the presentation.
11. If applicable, list any additional activities the speaker should attend during the event.
12. Indicate if you have a specific trainer or consultant in mind and provide their contact information if applicable. If not, describe the skills and qualifications you seek.
13. Define the expected audience for the technical assistance event, including anticipated participant numbers.
14. Select which service systems or organizations will participate in the TA event by checking the relevant boxes.
15. If your request may require funding, indicate if you have a training budget available for hotel, flight, or honorarium expenses.
16. Provide the name, cell number, and email address of an onsite contact person for handling last-minute issues.
17. Outline logistical needs such as equipment required for the presentation, including a laptop, projector, and screen.
18. Indicate how you learned about the organization and any SAMHSA funding you currently receive, as well as your interest in community groups.
19. Once all sections have been filled out, review the information for accuracy and completeness before saving your changes, downloading, printing, or sharing the form as needed.

Complete your Speaker Request Form online and ensure your event is covered by expert speakers.