Request A Speaker / Representative

Request A Speaker
Are you interested in requesting a speaker or representative of The Julian Center to come to your organization or participate in an event you are hosting?

If so, please complete and submit the following information at least 1 month in advance of your event and someone will contact you to discuss your request.

Thank you for your interest in The Julian Center! 

= required field







  Type of speaker / representative needed?: (Check all that apply) 

  Area of interest?: (Check all that apply)



Are you charging a fee to attend?:

Will the media be contacted regarding this event?:  

Will Facebook or other social media be used to advertise this event?:  



  Who is the audience?: (Check all that apply) 

In an effort to quell spam from this form, please type the following code before clicking submit.
 Security code

To leave this site at any time, click on the X tab to escape and we will redirect you quickly.

Please note that communications over the Internet are not confidential and can be traced. If you are in danger of being monitored, please use a safe computer. For more information on Internet Safety, click here.

If you need help, call The Julian Center 24-Hour Crisis Line at (317) 920-9320.