NC Council for Women Speakers Bureau Request Form

Thank you for contacting the NC Council for Women and Youth Involvement regarding your upcoming event. CFWYI will help identify the speaker who will be the best fit for your event. Please provide us information about your event. Below is a quick questionnaire to get the process started.

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Council for Women Speaker Request Form

Event Details

Event Name

Event Date / Time

Event Location

Event Purpose

Event Language

Event Website

Audience Size

Audience Description

Organization Details

Host Organization Name

Does the organization have a relationship with the Council for Women or another state agency?

Has a CFWYI speaker participated in your events previously?

Yes

Presentation Details

Presentation Format (check all that apply)

Keynote

Panel

Concurrent Session

What topic(s) would you like the speaker to address?

Are any other speakers invited? If so, who?

Requester Details

Your Name

Your Email Address

Your Phone Number

Your Location (Country)

This question is for testing whether or not you are a human

Off