Connections

Speaker Request Form
United Way of Calgary and Area

Speaker Request Form

Review the Agencies document below, then complete & submit this form
at least 2 weeks (10 working days) prior to your preferred event date.

Cancellations are requested with a minimum of 48 hours notice.

Please contact us at 403-231-2604 if you have any questions or need to cancel.

Agencies (pdf)
Please Review Before Requesting an Ambassador

Contact Information

LR Information

Company Information
Name*
Role
Phone*
Cell
Email*
Name
Phone
Attending yes:     no:
Attending in place of LR
Name*
Address*
Floor Room:
Building Name
Wheelchair Access? yes:     no:
Security check in required? yes:     no:
check in location Lobby:
Other:

Event Information
Date
Time AM: PM:
Speaker to arrive minutes prior
Audience Size approx.
Presentation length (min.)
10:
15:
Other:
Dress
business:
casual:
other: explain:
Event Description: (kick-off, leaders, lunch and learn, golf tournament, etc.)
Are you interested in a particular United Way focus area?
Role of Ambassador
Speak only:
Thank employees:
Participate in Q & A:
Other:
Comments:
Parking reimbursed by company? yes:     no:
Taxi / Transit reimbursed by company? yes:     no:
Nearest pay parking lot

Please enter the code below exactly as it appears

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