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.

If you are human, leave this field blank.

Speaker Request Form

Chapter *

Your Name *

Your Email *

Date submitted

Event Information

Event Name/Purpose

Target date range (Include preferred days of the week)

Event location

Apt, suite, etc.

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City

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Type of speaker requested

Reference the Chapter Event Speaker List to see speaker types.

Please list your choices in order of preference * **

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What is your budget range for a speaker

What is your maximum budget for a speaker

Any other information

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