1 Start 2 Complete Speaker Request Requested Speaker * Select a speakerBill FultonDr. Stephen KlinebergKyle SheltonDr. Ruth N. López TurleyJie WuMember of the Institute Staff Name * Email * Phone Number * Event Host * Topic(s) of Interest * Audience * What is the nature and anticipated size of the audience? Address * Where will the event be held? What is the address? AV Support * Will AV support be provided? (Projector, microphone, and computer) Event Date * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year201820192020 Time(s) Requested * Allocation * How much time has been allocated to the speaker? Alternative Date * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year201820192020 Type of Event * Is this a ticketed and/or a fundraising event? Yes No Additional information about the fundraising event If you answered "Yes" to the "Type of Event" question, please provide more information about the fundraising goals for the event. How much are tickets and/or tables? What are the registration fees for different levels of donors? Which organization(s) is benefiting from the event? How will the speaker(s) be featured on marketing and/or promotional materials? Note that the Kinder Institute for Urban Research will require review and approval of any collateral materials promoting the event, either in print or online. Speaker's Fee * Based on the Speaker's Fee information shared on the Speaker's Bureau page, which fee is applicable to your organization/event? Leave this field blank
