Speakers Bureau

Speakers requisition

Please fill out the following form completely to ensure a response. Once your request is submitted, you will be redirected to our Homepage.

Requested Speaker

Your First and Last Name

Your Organization

Event Title

Event Date

Event Start Time and Duration

Event Location

Describe the Event

Your Organization's Mission

Speakers Duties

Number Expected to Attend

Phone Number

Postal Code

Security Check

CONTACT INFORMATION:

20777 W. Ten Mile Rd.

Southfield, Michigan 48075