Islamic Networks Group

REQUEST A SPEAKER

To request an ING speaker, please complete and submit this form. In most cases, you will receive a response within 24 hours. If your request is a rush, please contact our office at (408) 296-7312. In general, allow up to two weeks for scheduling presentations.

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

Our presentations to K-12 schools are generally 55 minutes long. For other presentations, the speaking times may range from one to four hours.

1. Your Name:
2. Organization/School:
3. Organization/School Email:
4. Organization/School Address:
5. City, State, Zip Code:	,
6. Work Phone Number:	( ) - Ext.
7. Home Phone Number: (preferred for teachers)	( ) -
8. Best Time to Call:
9. Desired Outcome: (describe who the speaker will be addressing and what you would like the audience to learn from the speaker)
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 :
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13. Additional Comments:




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	"Ramadan - A Time for Change," ISNA 45th Annual Convention 8/29/2008 "Engaging the Other: The Power of Compassion," Common Bond Institute 3rd Annual Conference 9/4/2008 "Women and American Islam," Religion Newswriters Association 9/17/2008 "ING Annual Supporters Dinner and EID Holiday Celebration" 10/5/2008 "Getting to Know American Muslims and Contemporary Challenges," San Jose State University 11/3/2008 "Role of Women in Islam," Olive Tree Education 11/17/2008