Speaker Request Form Name of Organisation Purpose of Organisation Name and address of the person making the booking Telephone Your Email Address Name of person chairing the meeting (if applicable) Place of meeting Date & Time of meeting Alternative Dates (if possible) Time Speaker should arrive Approx time allotted for Speaker Would you be interested in using a pre-recorded video for part or all of the talk? (If yes there will be a chance to submit questions to BRACE via email to be answered soon after the meeting). Time meeting should finish Approximate numbers expected Does the venue provide IT facilities or if online Zoom or another video conferencing option? If so, what is provided? Is parking provided? Would you like the speaker to bring a selection of BRACE fundraising sales items? Any additional information you feel is relevant regarding the talk/meeting?