Please copy, paste, and fill out the form below in an email to Speakers Bureau Organizer, Hannah Willage

Speaker’s Bureau Request Form
Chicago Coalition for the Homeless

The Speakers Bureau is a team of formerly and currently homeless advocates who conduct presentations and forums on homelessness and other social issues. These presentations take place at universities, church groups, high schools and other institutions

Contact Information:

Name of Organization_____________________________________

Contact Person___________________________ Title _______________________

Telephone number____________________________ E-mail Address______________

Address________________________________________________________________

Logistics:

Dates and times of presentation, include time period allotted for our speaker:

Location of the Presentation:

How many people do you estimate will attend the engagement?__________________

Describe the audience in a couple of sentences, such as age and background:

Briefly describe your organization:

Suggested Donation:

We ask for a donation within the range of $150-$250 for Speakers Bureau event. We pay the two speakers a $30 stipend each. Additional funds are used for the professional development of our speakers and to support advocacy efforts to prevent and end homelessness. The amount suggested is $150-$250, but we are flexible according to the budget of each group. What amount would your organization be able to contribute?

Will your organization also be able to provide an additional contribution of $0.50 per mile of travel?

Further Infomation
How did you hear about the Speakers Bureau?

Along with homelessness, what topics would your group be interested in learning more about?
• Affordable Housing
• Living Wage Jobs
• Prostitution
• Re-entry after prison
• Youth
• Legislation
• Organizing
• Education rights of homeless children

Briefly describe the goals and outcomes you would like to see met during the presentation:

Would you like the presentation to be interactive:___________________

Any other information that you would like us to know as we craft the presentation for your organization:

Please return to Hannah Willage via e-mail: hannah@chicagohomeless.org and if you have questions please call 312-435-4548 ext 239.