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Speaker Request Form
Please complete and submit this form to request Professor Anastasia C. Curwood to speak about her forthcoming book, Shirley Chisholm: Champion of Black Feminist Power Politics. We will be back in touch with you within 72 hours!
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Email
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Your email
Name
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Your answer
Organization
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Your answer
Postal address
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Your answer
Describe your target audience.
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Your answer
Will your event be...
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Virtual/online
In-person
Hybrid
Book club
What date or dates are you seeking a speaker? First preference
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What date or dates are you seeking a speaker? Second preference
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What date or dates are you seeking a speaker? Third preference
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What are the goals of your programming?
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Your answer
Will you be selling copies of Shirley Chisholm: Champion of Black Feminist Power Politics at the event?
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Yes
No
What is your budget for programming?
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Your answer
Will your organization provide an ASL interpreter for the program?
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Yes
No
Will your program be recorded? Please note that Professor Curwood will retain copyright for her talk and recording of it.
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Yes
No
Are there other accommodations or considerations we need to know for your program?
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Your answer
A copy of your responses will be emailed to the address you provided.
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