UNI Speakers Bureau - Online Request Form

To request a speaker, please submit the form below to the Office of University Marketing & Public Relations. We will share this request with the appropriate UNI faculty and staff. You will receive communication regarding your request within one week.


Name: 

 

Organization/Business: 

 

Address: 

 

City: 

 

State: 

 

Zip: 

 

Home Phone: 

 

Work Phone: 

 

Fax: 

 

E-mail: 

 

Event Date: 

 

Time: 

 

Location: 

 

Audience Size: 

 

Topics Requested: 

#1
 

#2
 

#3
 

Specific Information: 

 
   
   

What is the nature of your event? 

 

 

 

Other Comments: 

 
 
 
 

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