Please complete these questions if you would like to request a speaker from Catholic Charities, Diocese of Youngstown, or any of its affiliate agency representatives.

Please submit requests at least 2 weeks in advance of the event/engagement opportunity.

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* 1. Contact Name

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* 2. Organization Name

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* 3. Location of Engagement / Event

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* 4. Contact Email Address

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* 5. Contact Phone Number

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* 6. Date for which you are requesting a speaker (if applicable)

Date
Time

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* 7. If date/time are flexible, please give us a range of options.

For example:
"We are looking for someone to come on a Friday afternoon, during October."

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* 8. Type of Engagement

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* 9. Requested Length of Speaking Engagement

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* 10. What is the name of, or type of event for which you are seeking a speaker?

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* 11. What topic would you find most appropriate for this engagement?

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* 12. What is the expected age range of participants?

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* 13. What is the expected number of participants?

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* 14. Is there anything else we should know about this engagement that would help us to choose the best speaker?

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