Pride Center of the Capital Region | Be proud. Live pride.

Speaker Request Form

Thank you for your interest in having the Pride Center of the Capital Region come and speak at your organization. We have a variety of topics we can address regarding LGBT issues and programs, as well as how to make your organization more LGBT- friendly.

Complete form BELOW, or send by fax or mail:

Please follow the steps below to complete your request:

1. Please complete the Speaker Request Form below, or by fax|

2. Fax or mail the form to the Pride Center at 332 Hudson, NY 12210 or Fax to 518.462.2101. You can email a PDF version to cstreett@capitalpridecenter.org

3. We will review all requests weekly and get back to you with our availability. Please include the deadline for your event on your Form.

4. Please include a contact person for us to follow up with in case we have additional questions.

Send Electronically:

Please complete your request below:

Contact Information

Name of group or organization:

Contact person:

Address:

City:

State:

Zip:

Telephone Number:

Fax Number:

Email:

Event Information

Date:

Time:

Location (address):

Type of event (e.g. panel, training session, workshop, etc.):

About how many people do you expect to attend and who is your intended audience (e.g. members of the LGBT community, staff of your company or organization, youth, etc.)?

Are any other organizations co-sponsoring this event with you?
Yes No If so, who?

What is the deadline by which you will need us to respond?
*

Speaker Information

What topic(s) would you like us to speak about?

How long should the representative be prepared to speak?

Will other organizations or individuals be speaking?
Yes No If so, who?

How did you hear about the Pride Center and why have you asked us specifically to speak?

Anything else we should know in order to consider your request:

The Pride Center of the Capital Region is a non-profit organization that relies primarily on donations. If necessary, would your group/organization be able to compensate us for travel and other expenses? Yes No

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Pride center of the Capital Region | Be proud. Live pride.

Speaker Request Form

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