North Carolina Council for Women Speakers Bureau Request Form Thank you for contacting the NC Council for Women and Youth Involvement regarding your upcoming event. The CFWYI Speakers Bureau 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. Indicates required field Name of Event Event Date / Time Event Date / Time: Date Event Date / Time: Time Location of Event Name of Hosting Organization Does the organization have a relationship with the Council for Women or another state agency? Purpose of the event Describe the audience Size of audience for the event What topic (s) would you like an CFWYI speaker to address What topic (s) would you like an CFWYI speaker to address - None -Employment and EarningsHealthDomestic ViolenceEconomic ProgressOther… Enter other… What is the language of the event? Has a CFWYI Speaker participated in your events in the past? - None -YesNo Presentation Format: (Indicate all that apply) Keynote Panel Concurrent Session Are any other speakers invited? If so, who? Website for the event? Your Name Your Email Address Your Phone Number Your Location (Country)
North Carolina Council for Women Speakers Bureau Request Form Thank you for contacting the NC Council for Women and Youth Involvement regarding your upcoming event. The CFWYI Speakers Bureau 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. Indicates required field Name of Event Event Date / Time Event Date / Time: Date Event Date / Time: Time Location of Event Name of Hosting Organization Does the organization have a relationship with the Council for Women or another state agency? Purpose of the event Describe the audience Size of audience for the event What topic (s) would you like an CFWYI speaker to address What topic (s) would you like an CFWYI speaker to address - None -Employment and EarningsHealthDomestic ViolenceEconomic ProgressOther… Enter other… What is the language of the event? Has a CFWYI Speaker participated in your events in the past? - None -YesNo Presentation Format: (Indicate all that apply) Keynote Panel Concurrent Session Are any other speakers invited? If so, who? Website for the event? Your Name Your Email Address Your Phone Number Your Location (Country)
