UWM Speaker Request Form

Thank you for your interest in having a United Way of the Midlands staff member speak to your group. We are excited to share information about our investments, programs, and data that highlight the impact we are making in our community.

Please complete the form below to request a speaker. Once submitted, a member of our team will contact you to confirm the details and discuss your specific needs. We look forward to the opportunity to engage with you and provide insights into the work we are doing to create lasting change in the region.

First name*

Last name*

Phone number*

Email*

Organization*

Date of Event*

Month/Day/Year

Time of Event*

Event Location Name:*

Size and Description of Audience*

In Person or Virtual*

In Person

Virtual

What A/V options are available?*

Microphone

Screen/Projector

Email Slides Ahead of Time

Other

Special Instructions (Parking, Security)*