Speaking Request Form

Please complete and submit the following form to request a speaking engagement with Attorney General Daniel Cameron.
*Submission of a form does not confirm attendance at an event. A member of our scheduling team will reach out regarding your request.

* Name of Organization:

* Point of Contact Name:

* Point of Contact Title:

* Point of Contact Phone:

* Point of Contact Cell Phone:

* Point of Contact Email:

* Security Detail Point of Contact Name:

Security Detail Point of Contact Title:

Security Detail Point of Contact Phone:

* Security Point of Contact Cell Phone:

Security Point of Contact Email:

* Name of Event:

* Event Date:

* Event Start Time:

* Event End Time:

* Time Zone:

* Venue / Location:

* Venue Address:

* Venue City:

* Venue State:

* Venue Zip Code:

* Nature of Program and Agenda:

* Please list preferred speaking topics:

Upload run of show, program, relevant event, cause or organization information and any suggested talking points:

* Time of Appearance/Expectations:

Please include details like suggested arrival time, speaking duration, seating assignment, speaking order and anticipated speaking start time.

* Will media be in attendance?

* Target Audience:

* Number of Attendees:

* List of Attendees:

* Event Attire:

* Food / Meal Provided:

* Dignitaries or Speakers Participating:

Please note invited or confirmed.

* Organization and Event Website:

Additional Notes:

* If Attorney General Cameron is unable to attend, is a surrogate appropriate?

Verification

ATTORNEY GENERALDANIEL CAMERON

Secure Online System

Speaking Request Form