Minnesota Multifaith Network

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About Us
Network + Connect
Resources
Membership
- Membership Information
- Member Login
Donate

Speakers Network Presentation Request Form

Name

Phone

What topic (or topics) do you want the speaker (or speakers) to cover?

What is the theme of the program you are planning?

Which of these speakers relates to your event's intended focus? Select all that apply.

Multifaith Panel (please also check all boxes below that apply to your multifaith focus) Buddhist — General Christian — African American Christian — General Hinduism — Hindu Society of Minnesota Islam — Islamic Resource Group (IRG) Jainism — Jain Center of Minnesota Jewish — Jewish Community Relations Council (JCRC) Native American — Healing Minnesota Stories

Desired outcome (what you hope to receive from the speaker or speakers):

Presentation Type

One-time event Multi-week event

What is your preferred presentation format?

Virtual/online only In-person only Hybrid of virtual/online and in-person Unsure at this time

Audience Type

School (all grade levels, including colleges/universities) House of Faith Community Learning Business Group Friends' Group

Street Address

City

Zip

Preferred Event Date

Preferred Event Start Time

Preferred Event End Time

Additional Comments (alternative dates, any special considerations regarding class/technology/space etc.).

Please include a cell phone number for pre-event communication, if possible.

Please indicate if you are able to contribute either or both of the following:

Administration fee ($50) Speaker honorarium (based on your budget)

Amount Budgeted for Honorarium: