REQUEST FORM FOR SPEAKING ENGAGEMENT

Grandmothers Against Gun Violence is committed to sharing our knowledge and expertise to engage and educate communities on the issues, challenges and societal impacts of gun violence. Please complete the following form to request a GAGV speaker at least 45 days before your event. A member of our team will get back to you pending review of your submittal.

Your Name: *
Your Name:
Phone: *
Phone:
Date of Event: *
Date of Event:
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Event Location: *
Event Location:
Start Time: *
Start Time:
End Time: *
End Time:
Please select what topics you would like GAGV to cover (check all that apply): *