Request a speaker If you would like to request a Domestic Minor Sex Trafficking awareness presentation for your event, please fill out and submit the form below.Contact Information* First Name Last Name Email* Phone*Please check the box that best characterizes your groupSchoolCivic GroupFaith GroupOtherEvent Information Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Site of Event (Please include site name, if applicable.)Date of Event Event Time : HH MM AM PM Time Speaker Must Be Present : HH MM AM PM Length of time given to Street Grace speaker*15 Minutes30 Minutes1 Hour2 HoursWould you like The Candy Shop video to be shown at your event?YesNoPlease note that a showing of The Candy Shop requires a minimum of 1 hour.Other speakers you will be inviting to the event:Expected number of attendees:Additional Questions or Comments:Phone number for contact who will be on site the day of the event, if different from above.I understand that this form operates only as a request. The completion and submission of this form does not signify that Street Grace has agreed to participate in my event. Furthermore, I understand that any and all speaker requests are fulfilled on the basis of availability and cannot be guaranteed.* I acknowledge the above disclaimer.