Chapter Event Speaker Request

Please complete the form below to request a speaker for your chapter event.

Many speakers require use of the University plane.
Scheduling is dependent upon the speaker’s availability as well as the plane’s availability.
Speaker honorariums may change depending on travel involved.
NAA covers all travel expenses for speakers coordinated through our office.
NAA is not under contract with any speakers, so there is no guarantee of their availability.
We do not recommend having more than one speaker for an event, unless you are having an emcee and a speaker.

Speaker Request Form – imported

Chapter(Required)

Your Name(Required)

Your Email(Required)

Date submitted

Event Name/Purpose

Target date range (Include preferred days of the week)

Event location

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Type of speaker requested

Reference the Chapter Event Speaker List to see speaker types.

Please list your choices in order of preference * **

First

Second

Third

Fourth

What is your budget range for a speaker

What is your maximum budget for a speaker

Any other information