Speaking Engagement/Event Request Form « The Official Website for the City of Birmingham, Alabama

Speaking Engagement/Event Request Form

All forms should be completed and submitted at least 21 business days in advance of the event

The completion of this form does not confirm acceptance

Speaking Request Form

Event Name*
Requesting Organization*
Event Locations*
Website (Eventbrite, Organization website, etc.)
RSVP needed by (DATE)
MM slash DD slash YYYY
Event Date*
MM slash DD slash YYYY
Event Start Time*

: Hours

Minutes

AM/PM

All times must be listed in Central Standard Time.
Event End Time*

: Hours

Minutes

AM/PM

All times must be listed in Central Standard Time.
Contact Person for the Event*
First Last
Are you willing to have a designee of the Mayor to come speak?*
How long is the Speaker required to be present for the event?*

For the entire event or from __am/pm to __am/pm?
Contact Person Email*
Contact Person Phone Number*
Physical Address of Event Location*

Please include room and floor number, special directions, or any additional details)
Dress Code (If Applicable)
Event Theme (If Applicable)
Is there a topic or subject that should be addressed in Mayor Woodfin's remarks?
Does the group have any special causes or concerns that should be addressed?
Preferred length of comments
Are there people in the audience that should be recognized? (dignitaries, politicians, donors, etc.)? If so, who?
Are there any other speakers? If so, who?
How many people will be in attendance?*

If exact number is unknown, please provide an estimated number.
What is the age range of the audience?
Additional Details
Who is the target audience?*
Is a program for the event available
If a program is available, please attach the document below. If you will have the program ready at a later date, you may email the program to Sylvia.Bowen@birminghamal.gov
File Upload
Drop files here or

Accepted file types: jpg, gif, png, pdf, Max. file size: 20 MB.
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Birmingham, Alabama: Putting People First

Speaking Engagement/Event Request Form

All forms should be completed and submitted at least 21 business days in advance of the event

The completion of this form does not confirm acceptance

Speaking Request Form