Elizabeth Glaser Pediatric AIDS Foundation : Event Speaker Request

Event Speaker Request Form

Thank you for your interest in having a speaker at your event! Please fill out the form below to provide us with important details about your event and the type of engagement you're looking for. This will help us match you with the right speaker and ensure everything runs smoothly. We’ll be in touch soon!

Event Name *

Event Date & Time *

Event Location *

Number of Guests Expected *

Type of Event *

Dance Marathon
Fundraiser
Gala
Auction
Other

Event Theme

Fundraising Goal *

Event Link

How long would you like the speaker to present? *

What Are You Looking for From the Speaker? *

First Name *

Last Name *

Email Address *

Phone Number *

Deadline to Receive an Answer *

Length of the Event

Is There Any Additional Information the Speaker Should Know?