Speaker Request Form:

Thank you for reaching out to have LULAC represented at your event.

Event Organizer

Email*

First Name*

Last Name*

Phone*

Organization Requesting

Organization Type

Event Name/Title

Event Location

Event date and Time

Event Type

Purpose/Goal

Event Website

Topic

Format

Event Duration (hrs, min)

Questions & Answers

Size of Audience

Media Invited

Deadline for Aceptance

Cost of Attendance

Offer of Payment/Reimbursement

Disclaimer/Release Form

Honorable Guests: (List names and titles of members of Congress, CEOs, or other VIPs participating in, or attending the event.) *

* Required information