Faces of Homelessness Speakers' Bureau Event Request
The Faces of Homelessness Speakers’ Bureau travels throughout the state of Connecticut (and beyond) to share their own experiences of homelessness, dispel myths, educate audiences on the causes of homelessness, and encourage others to get involved in making positive changes in the community.

Typical Events Include:
  • Overview of Homelessness
  • Speakers' stories
  • Q & A session
  • Ways you can get involved
For each speaker, a $250 honorarium fee is applied, please inquire about pricing.

To request a Faces of Homelessness Speakers' Bureau event, please fill out and submit this form. Following submission, the Community Engagement department will contact you within 1-3 business days. 
Sign in to Google to save your progress. Learn more
Organization/Institution: *
Sub-organization/Department/Group:  *
Name: *
Email: *
Organization Mailing Address: *
City: *
State: *
Zip Code: *
Event location address (if different than above):
Work Phone: *
Cell Phone:
Fax Number:
What is your position in the organization? *
Where will the event be located? *
Will you be present at the event? *
Event Date: *
MM
/
DD
/
YYYY
Event Time: *
Time
:
Where can we park? *
Who will meet us? *
What time would you like us to arrive? *
Time
:
Is the facility handicap accessible? *
Will food be provided either before or after the event? *
Are there any amenities you are able to provide at this location? (ie. microphones, tables, chairs, stage, projection screen, etc.)
How many speakers would you like on the panel? *
If you have seen the panel before, would you like to request a specific speaker(s)?
Do you have a particular subject focus or audience need? (ie. homeless families and children, housing issues, health care, policy, re-entry/prison, mental health, substance use, HIV/AIDS etc.) *
What is the format of the event? (ie. keynote, workshop, class, discussion etc.) *
Please describe the audience in terms of size, age, and previous knowledge about hunger, homelessness, and poverty issues: *
Other comments/questions/requests: *
Is your group interested in working with us beyond the speaking engagement? *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy