Request an AAPLOG Speaker Request a Speaker - AAPLOG Speakers’ Bureau Organization or Group Name Type of Org (School, PCC, national non profit, etc) City State Website/URL: Contact Name Contact Name First Name First Name Last Name Last Name Email: Phone: Type of Event Please give us some details about your event (ie, annual gala, national or state conference keynote or breakout, legislative day/rally, student group, pregnancy center banquet, etc) Date of Event Location of Event Event Website/URL Audience (approximate size and composition) Time/time zone Length of talk Speaker requested Name or Topic (we can help fine one!) Fee range Under $2500 $2500-5000 Over $5,000 OtherOther Who are the other speakers? Travel costs covered? Yes No Comments Important Notes: Thank you for being interested in an AAPLOG speaker! Once your request is reviewed, we will reach out to you with possible speakers and discuss further details. Please note that the speaker honorarium will be split between the speaker (90 percent) and AAPLOG (10 percent). Submit If you are human, leave this field blank.
