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Speaker Request Form

(To be filled out by teacher)

One form per request please!

* Purpose of Request:       Constitution Day       Law Day       Other

* Teacher Name

Cell or Home Phone

* E-Mail Address

School Phone
May we use your email address to contact you about Law Day (May) and Constitution Day (September)?
Yes       No

Fax Number

School Name

School Address
Address (cont.)

Grade Level

Room No.
No. of Students  

Presentation Date Requested
Please submit this form at least two weeks in
advance of your requested speaking date.
Is this time or date flexible?
    Yes       No
        a.m. p.m.
Requested Start Time
(30 minutes to 1 hour is usually adequate.)
    a.m.   p.m.
Requested End Time

Attorney Name (if you have a request or have already made arrangements with someone)

Topic Requested (click for ideas):

Please indicate if there is a particular area you are covering that will tie into the subject matter

Parking Instructions and Additional Comments

You must be present at the time the attorney speaks to your classroom. Please do not schedule a substitute teacher for that day. A separate form must be submitted for each speaker requested.

Classes may be combined. We suggest that no more than two different grade levels be combined and that they be consecutive grade levels (e.g., 1-2, 4-5). The total classroom size should not exceed 40. If you have a larger group, we suggest dividing the group, and we will provide additional speakers.
Please be as accurate as possible on the number of students who may attend so the lawyers can bring adequate amounts of any material or handouts they prepare.