Northwest Lawyers
and Artists (NWLA) Speaker Request Form
NWLA offers informative and entertaining presentations to artists, writers,
designers, musicians, filmmakers and other creative business people on the areas
of the law affecting them. Learning about the facilities available, the people
we are addressing, and the specific areas of interest of the participants is
very helpful in tailoring a specific program for your organization or group.
Please complete this form and return it to: Northwest Lawyers and Artists, c/o
Kohel Haver, Esq., 621 SW Morrison Street, Suite 1417, Portland, OR 97205, fax
number (503) 295-2737 or e-mail
nwla@aracnet.com.
1. Date and Time (When and for how long would you like our presentation to last?):
2. Location (Please attach a map and / or directions to your location):
3. Type of facility (classroom, auditorium, theater, etc.?):
4. Parking Availability (off-street, metered, garages / lots?):
5. Equipment Availability (blackboard, podium, audio/visual equipment?):
6. Number of participants expected? (We generally prefer 15-40):
7. Is the meeting open to the public? (May we invite guests?):
8. Refreshment Availability (coffee, lattes, catering?)
9. Type of Audience: (What is the general composition of the group? e.g., students,
working artists or craftspeople, hobbyists, small business owners.)
10. Preferred Topics of Interest:
(a) What are the professional concerns of the
group?
(b) What specific topics, legal or other, would you like covered?;
(c) Do you have any particular questions for us to answer?
11. Expenses:
(a) Do you offer reimbursement for travel expenses? (If travel outside of the
Portland area is required):
(b) Do you have a budget for handouts? (Can you cover the cost of handouts or
other materials):
(c) Is there an honorarium available for NWLA? (Our suggested range is $75 -$300):
12. Will there be a press release? (If so, we can give you biographical information
on our organization and speakers. Please send us a copy for our records):
13. Contact Information (Please fill in below):
_____________________________________________________________________________________________________
Organization Name:
_____________________________________________________________________________________________________
Contact Person(s):
_____________________________________________________________________________________________________
Telephone:
_____________________________________________________________________________________________________
Fax:
_____________________________________________________________________________________________________
E-mail:
_____________________________________________________________________________________________________
Address:
PLEASE SIGN AND DATE SPEAKER REQUEST FORM BELOW:
_____________________________________________________________________________________________________
Organization Name
_____________________________________________________________________________________________________
Your Name
_____________________________________________________________________________________________________
Date