Information For Speaking
Engagements
For The Surrogate
Name
of Organization:_________________________________________
Location:___________________________________________
___________________________________________
Dates
(Please list at least 3):
______________________
______________________
______________________
Time: _____________________
Approximate
Speaking Time:
______________________________
Contact
Person & Title:____________________________________________
Address:
____________________________________________________
____________________________________________________
Telephone:_____________________________________
Attendance:____________________________________
Topic:_________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Newspaper
Announcements?
Yes______ No_______
Parking
Space Available?
Yes______ No_______
If
Yes, where?
________________________________________________________________________
If
No, is there parking close by?
Yes______ No_______
Where?
________________________________________________________________________