Speaker Request

The Maryland Food Bank appreciates your interest in our work. In order to determine whether or not we can accommodate your request for a speaker, please provide the requested information below. Please note: requests for speakers must be submitted at least four (4) weeks prior to your event.

Completion of this form does not guarantee a speaker

Please fill out this form

Contact Information
Organization
Contact Name*
First Last
Contact Position
Contact Phone
Contact Email*
Website URL
Please Describe Your Event or Program
Name of Event
Event Date
Start Time

: HH

MM

AM/PM
End Time

: HH

MM

AM/PM
Location Name
Location Address Address Line 2 City State ZIP Code
What is the Theme/Purpose of the Event?
Proposed Topic(s)
Length of Expected Presentation

: HH

MM
Presentation Format (panel, speech, roundtable, etc.)
Other Invited Speakers
Audience Composition
Approximate size of audience expected
To what level of experience is this program directed?
To what specific type of audience is this program directed?
Written Materials/Biography (if applicable)
Due date for written materials and biography
Email address where written materials and biography should be sent
Audio/Visual Equipment
Is audio/visual available to be used?
- Yes
- No
Due date for submission
Contact person for audio/visual arrangements
First Last
Will this event be videotaped, recorded or transmitted live on social media?
- Yes
- No
If so, please provide access information*
Please provide any additional information pertinent to this request, including information from past events such as a list of former speakers.

Please fill out this form

Contact Information

Please Describe Your Event or Program

Audience Composition

Written Materials/Biography (if applicable)

Audio/Visual Equipment

Baltimore Office

Eastern Shore Branch

Western Branch

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