Primary Contact: First Name *

Last Name *

Primary Contact Phone *

Primary Contact Email *

Organization Name *

Organization Phone

Organization Address - Line 1 *

Address Line 2 *

City *

State *

ZIP Code *

Organization Type *

Government Institution

Professional Group

Religious Institution

Student/School

Other

Describe Audience *

Briefly describe your audience. If a school group, please specify grade level(s).

What topic(s) would you like covered?

Holocaust

Genocide

Antisemitism

About the THGAAC (our commission)

Other

Presentation Location/Address *

First Choice Presentation Date and Time *

Second Choice Presentation Date and Time *

Are these dates flexible? *

Yes

No

How many presentations are you requesting? *

How many audience members will attend each presentation? *

What presentation form do you prefer? *

In-person

Virtual

No Preference

I acknowledge that the hosting organization is responsible for providing an accessible entrance for the speaker, seating for the speaker, a microphone, and equipment necessary for a PowerPoint presentation. *

How did you learn about the THGAAC’s Speaking Services?

Please select one.

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