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Speaker's Fund Request 

 

Speaker's Name:
Speaker's Phone:
Speaker's Email:
Date of Event:
Projected Audience Size:
Requesting Organization:
Organization Location:
Organization Contact:
Organization Contact's Phone:
Estimated Travel Costs:

Description of the Speaking Appointment and the Value

to Southern:

Is the requesting organization willing to pay for lodging?

 

Is the requesting organization willing to pay for meals?

 

(All fields required)

 

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