Office for Civil Rights Speaker Request

Thank you for your interest in having someone from the Office for Civil Rights speak at your event. Please submit this completed form to help us evaluate your speaker request.

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Sponsor Information:

Sponsoring Organization:

Point of Contact Name:

Title:

Ext:

Email:

Event Information:

Event:

City:

State:

Venue:

Event Website URL:

Type of Event:

Type of Audience:

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Number of Attendees:

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Requested OCR Presentation:

Type

Please describe what topic(s) you would like the speaker to address:

Length of Time:

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Requested Materials:

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Type of Audio/Video and IT Provided:

Cost $

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Cost $

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What is the cost for federal government attendees? Cost $

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Please use the text box below to provide any additional information you wish OCR to know about the event. For example, accommodations needed such as documents in Braille or large print; Section 508 compliant presentations, etc.

Office for Civil Rights Speaker Request

Event Information:

Requested OCR Presentation:

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Office for Civil Rights Headquarters