Speakers Bureau Request Form

Speakers Bureau Request

If your organization would like to book a speaker, first contact the speaker to confirm program dates, times, and whether or not the program will be offered virtually. After you have confirmed scheduling details, submit a speaker request form to Ohio Humanities at least six weeks before the presentation takes place. Upon approval, we’ll send you a program agreement packet and ask you to pay the appropriate application fee to Ohio Humanities. Groups are limited to three Speakers Bureau programs per year.

Speaker Fee Structure

Non-profit organizations with an annual budget under $150,000 pay a fee of $50.00.
Non-profit organizations with an annual budget over $150,000 pay a fee of $250.00.
Schools (including colleges or universities) and corporate or private entities pay a fee of $400.00.

For more information, please visit ohiohumanities.org/speakers-bureau/.

For any questions, please contact Program Officer Melvin Barnes at mbarnes@ohiohumanities.org.

Registration

As the person completing this application, please provide the following information.

Name of Individual Completing the Form*

Prefix (optional)

First Name

Last Name

Individual's Title*

Individual's Organization*

Individual's Email*

Individual's Phone*

Sponsoring Organization

Sponsoring Organization*

Sponsoring Organization Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Sponsoring Organization Phone*

Sponsoring Organization Website

Organization Type*

Non-profit Organization with an annual budget under $150,000 Non-profit organizations with an annual budget over $150,000 Schools (including Colleges or Universities) and Corporate or Private Entities

Organization's Annual Budget*

Your organization's approximate annual budget.

EIN

Tax ID (Optional)

UEI

Unique Entity Identifier — https://sam.gov/content/home

Project Director

The project director is the person responsible for coordinating the project, serving as the liaison with Ohio Humanities staff.

Project Director Name*

Prefix (optional)

First Name

Last Name

Project Director Title*

Project Director Organization*

Address same as Sponsoring Organization?*

Yes No

Project Director Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Project Director Email*

Project Director Phone*

Lecture Request

For a list of Speaker, Topics, and Lectures, please visit ohiohumanities.org/speakers-bureau/

Speaker and Title*

Choose the Speaker and Title

Date Requested*

Must be at least 6 weeks from time of request.

Time of Presentation*

Type of Program*

Lecture Location

Location same as Sponsoring Organization?*

Yes No

Location Name*

Location Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Confirmed with Speaker?*

Yes

You must confirm with Speaker before submitting your application.

Anticipated Audience Size*

Speaker Fee Structure

Status

ProgramType

Save and Resume Later

Progress