Request a Speaker from DHR Complete this form to request a speaker for your organization or event. Fields marked with an asterisk "*" indicate a required field. Name of person making the request * Organization * Email * Phone number * Event Information Date Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20192020202120222023 Time Hour Hour123456789101112 : Minute Minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 am pm Is there an alternate or additional date and/or time? None Alternate Additional Alternate/additional time Date Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20192020202120222023 Time Hour Hour123456789101112 : Minute Minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 am pm Event location Name of the event Please describe the event Audience How many people do you expect to attend? Is media expected at the event? Yes No Maybe Speaker Speaker requested Commissioner First Deputy Commissioner General Counsel Regional Director For how long do you need the speaker to speak? Will slides or other material be needed? Yes No Not yet determined Optional Response Date you need a response by Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20192020202120222023 If we cannot attend your event, but you would you like us to provide you with informational materials, please provide the address where our materials should be sent to Leave this field blank