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Speaker Request Form

Please complete the form below to request For America President David Bozell to speak.

David Bozell is President of For America, the largest-of-its-kind, award-winning, national grassroots organization championing American exceptionalism.

For America, with its 8-million-member audience, is dedicated to using digital media to advance freedom, prosperity, and virtue in all public policy debates, and was labeled by the New York Times (😳), “One of the great unexpected influences of the [2016 Presidential] election.”

David regularly appears in print and on broadcast as a conservative pundit as well as an expert on the intersection of social media and politics.

Speaker Request Form

First Name

Last Name

Email

Phone

Organization

Event Date required

Event time

Date Response Required

Event Title

Event Type

Goal of the Event

Dress Code

Estimated Number of Attendees

Demographics of Attendees

Espected Length of Speech

Q&A

Desired Topic for Speaker to Address

Honorarium or Donation Amount

Invited Media/Press

Promotional Material

Event & Venue Information

Name of Event Venue

Address of Event Venue

Closest Airport and Distance

Event Layout?

Recommended Accomodations

Can you confirm that you will provide audio and visual equipment, and the ability to show a video?

Event Expense Coverage Requirements

In addition to an honorarium, For America also requires that the following expenses be covered by the event host.

TRAVEL: Round trip travel expenses for up to two people to be confirmed. Includes paying for:
- Air fare
- Car Rental
HOTEL: Up to two nonsmoking hotel rooms at a location with dining on the grounds, with meals billed to the rooms.
MISCELLANEOUS EXPENSES: Taxi fees, meals while traveling, and other incidentals billed to the event host after the event.

Thanks for submitting!

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