Speakers Bureau Request Form

Please copy and send the form below via email to Speakers Bureau organizer Hannah Willage

Speakers Bureau Request Form

Chicago Coalition for the Homeless

The Speakers Bureau is a team of homeless and recently 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 community venues.

Contact Information:

Name of Organization: __________________________

Contact Person: _______________________________

Title: ______________________________________

Telephone number: ____________________________

Email Address: _______________________________

Mailing 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 of $150-$250 for a Speakers Bureau event, but we are flexible according to the budget of each hosting group. We pay two speakers a $30 stipend each for events in Chicago and $50 per speaker for events beyond Chicago city limits. Additional funds are used for the professional development of our speakers and to support advocacy efforts to prevent and end homelessness.

What amount will 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 Information:

How did you hear about the Speakers Bureau?

Along with homelessness, what topics would your group be interested in learning more about?

- Homeless families and affordable housing

- Homeless youth

- Educational rights of homeless students

- Surviving prostitution and human trafficking

- Job training and living wage jobs

- Community organizing and shelter outreach

- Community reentry after incarceration

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 a presentation for your organization:

Please email to Hannah Willage: hannah@chicagohomeless.org

Questions? Please call (312) 641-4144, ext. 239.