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Year 'Round Speakers
Online Speaker Request Form (To be filled out by teacher)
One Form per Request Please!
*
Teacher Name
Home Phone
*
E-Mail Address
School Phone
Fax Number
School Name
School Address
Address (cont.)
Grade Level
Room No.
No. of Students
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Date Requested
Is this time or date flexible?
Yes
No
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Requested Start Time
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Requested End Time
(30 minutes to 1 hour is usually adequate.)
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
Additional Comments
PLEASE READ
: 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 group 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. Please do not schedule an attorney to speak if a substitute teacher will be in your class that day; please reschedule with the attorney for a day you will be present.
Please submit this form at least two weeks in advance of your requested speaking date.