Book an Event / Speaker Request Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Thank you for requesting a speaker from Patriot Academy.

Because of the volume of requests we receive, it may take up to two months or more to provide an answer regarding the availability of a speaker. We have not yet been able to look at all the requests for 2024 due to events we have committed to that do not yet have scheduled dates.

Thank you for your patience.

Email *

Name of Requested Speaker or Event *

Rick Green

Comedy & Constitution

Nathan Macias

Patriot Academy Alumni Speaker

Guest appearance for a Constitution Coach or Biblical Citizenship Class

Event Name and Description *

Organization Name *

Event Date *

YYYY

Event Location *

Event Start Time *

Time

Event End Time *

Time

Length of Session *

Closest Airport *

Travel Time to the Airport

Will You Provide Transportation to the Airport?

Yes

Clear selection

Attire for the Event *

Number of Expected Attendees *

Description of Expected Audience (e.g., students, professionals, congregation, legislators, etc.) *

Please indicate the topic you are interested in *

Other possible participants

Confirmation Deadline *

YYYY

Additional Notes

Contact First Name *

Contact Last Name *

Contact Phone (Mobile preferred) *

How did you hear about us?

COVID19 NOTICE: After much research and study of the science, the data, and the virus, Rick has chosen to "Live Not By Lies." While there are many opinions about masks and other non-pharmaceutical interventions, there is only one set of actual facts. The masks are nothing more than virtue signaling at best, symbols of control at worst, and unquestionably causing more health risk and harm than good. Rick's conscience will not let him participate in the perpetuation of the greatest fraud on the American people that has ever occurred. The deaths, psychological damage, economic destruction, and societal division created by the fiasco of the government response (NOT by the virus) has gone on too long and Rick passionately opposes anything that continues to encourage people to live by dehumanizing fear and prevent the basic human interaction needed for a functioning society. Therefore, if speaking at your event requires covid testing, contact tracing, masking, or any other unwarranted "protocol," Rick will be unable to participate. *

I have read and acknowledge receipt of this disclosure.

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Patriot Academy. Report Abuse

Forms