Speaker Request Form

(To be filled out by teacher)

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: Law Day speakers are available April 22-May 10, 2013. Deadline for submitting Law Day requests is March 29, 2013.	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

PLEASE READ: You must be present at the time the attorney speaks to your classroom. Please do not schedule a substitute teacher for that day. Please submit a separate form for each speaker requested. Please submit this form at least two weeks in advance of your requested speaking date. 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 submit a separate request for each group. Please be as accurate as possible on the number of students who may attend so the lawyers will be able to provide adequate amounts of any material or handouts they prepare.