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Speaker Request Form

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Thank you very much for your invitation for Brenda Campbell to speak at your event. We receive numerous requests throughout the year. To facilitate our ability to give your invitation full consideration and make a prompt decision, please provide us with as much detail as possible at least 3 months in advance of the event date.


Under ordinary circumstances, you should expect to hear back from us within two-three weeks of receiving your invitation so you can proceed with your plans. Invitations to events that fall short of the 3 month advance notice may still be considered depending upon the situation.

REQUEST FORM

Name*

Email Address

Message*

Phone*

Date of Event

Location

Time

Length of Presentation

Type of Presentation

What role do you wish for Ms. Campbell to fulfill for this event?

Response Due Date

Honorarium Available:*

If yes, what will be the honorarium amount?

Please note to secure Ms. Campbell's services from USSMC, an honorarium is required. An invoice will be submitted by USSMC and within (5 business days) payment is expected, unless otherwise agreed. However, all non-paying honorariums must be approved by the USSMC Finance Division. Further discussions will be held to determine why an honorarium is not available. If transportation, lodging and per diem are required for Ms. Campbell, then the organization requesting her services is expected to make the arrangements to ensure all expenses are paid.

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