Islamic Networks Group

REQUEST AN ISLAMIC SPEAKERS BUREAU PRESENTATION

To request an Islamic Speakers Bureau (ISB) presentation, please complete and submit this form. In most cases, you will receive a response within 24 hours. To speak with the ING Scheduler, contact Everett DePangher at 408.296.7312. In general, allow up to two weeks for scheduling presentations.

ISB speaker presentations are provided to K-12 schools, colleges and universities, faith-based organizations and other non-profit institutions at no charge. We also offer cultural competency training and professional development to school districts, higher education institutions, corporations, law enforcement agencies, hospitals, community centers, and social service agencies. To support our educational outreach programs, donations are welcome from all organizations.

Our presentations to K-12 schools are generally 55 minutes long. For other presentations or training workshops, the speaking times may range from one to four hours. We will try our best to accommodate your requests with speaker volunteers who are certified after a rigorous process of professional development, testing and evaluation. Presentations are based on speaker availability. ING will do its best to meet your choice of presentation but cannot guarantee all requests. Speakers will bring a laptop and will need an LCD projector for the presentation.

1. Your Name:
2. Your Email Address:
3. Organization/School Name:
4. Presentation Location Address:
5. City, State, Zip Code:	,
6. Work Phone Number:	( ) - Ext.
7. Cell Phone Number: (preferred for teachers)	( ) -
8. Best Time to Call:
9. Choose a Presentation:
10. Optional Dates for Presentations:	/ / / / / /
11. No. of Periods Requiring a Speaker: (teachers only)
12. Start and End Times of Periods Requiring a Speaker: (please be accurate as possible for proper scheduling)	: To :
	: To :
	: To :
	: To :
	: To :
	: To :
	: To :
13. Desired Outcome: (describe who the speaker will be addressing and what you would like the audience to learn from the speaker)




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