Request a Speaker

We require an audience of 20 or more. We are limited to venues within a 40 mile radius of Ann Arbor.

Group Name:
Today's Date:

Contact Person

Contact Name:
Address:
City & State:
Zip:
Daytime Phone:
Fax:
Email:

Topic Preference

First Choice:
Second Choice:

Event Details

Date:
Time:
Location:
Indicate expected length of talk: 30 minutes
One hour
90 minutes
Two hours
Indicate expected audience size:
 

updated 01.2011

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