Dr. Boesak Speaker Request Form

If you are interested in having Dr. Boesak speak at an event, please complete this form.
  • Enter your full name.
  • Enter the best email address to reach you.
  • Enter the best phone number to reach you.
  • Enter the name of the organization requesting the speaker.
  • Copy and paste a link to your organization's website.
  • Enter the name of the event you would like Dr. Boesak to serve as a speaker.
  • Clearly state the subject you would like Dr. Boesak to speak about during his presentation.
  • Enter the name of the venue where the event will take place.
  • Enter the date and time of the event and indicate if it is in the a.m. or p.m.
  • Enter the city and state where the event will take place.
  • Select the option that best describes your event.
  • If you selected "other" in the last field, please explain the format of the event.
  • Briefly describe who will be attending the event.
  • List any event sponsors and/or partners.
  • Include additional details or descriptions you would like us to know about your event.
  • Clearly state why you would like Dr. Boesak to speak at your event.
Contact Us

Thoughts or Questions? We'd love to hear from you.

Not readable? Change text. captcha txt