Speaker Request Form - Laity - Archdiocese of Seattle

Speaker/Presenter Information:

A minimum of eight weeks is required to complete the request. Submissions outside of this timeline are not guaranteed to receive clearance. Approved requests will be provided via email correspondence.

Name

Title/Occupation:

Diocese of Residence:

Parish:

Parish Phone:

Parish Fax:

Parish Address:

Address Line 1

City

State

Zip Code

Pastor:

Type of Ministry

(e.g., speaker, musician, support person, etc.)

Event Information:

Title:

Date(s):

Location:

Audience:

Will the presenter have access to youth or vulnerable adults? If yes, then describe interaction:

Yes
No

Interaction Description:

Host Contact Information (Requester):

Name:

Title/Occupation:

Parish/Organization:

Requester Address:

Address Line 1

City

State

Zip Code

Email

Phone:

Fax

Please verify that you have completed an extensive internet background check on the proposed speaker to verify that his/her presentations conform to Church teaching on this requested topic:

Yes

List the topics or describe the content at which this person will be speaking.

Has this person spoken or ministered to this audience before? If yes, when was the event and what are the reasons for having he/she return?

Are you aware of any divergence on this speaker’s past from any Church teachings or any people who might find the speaker or his/her content controversial, unorthodox or problematic? If so, please describe…

Important Follow-Up Tasks to Complete

After submitting this form, please email the following supporting documents to beata.gando@seattlearch.org.

  A letter from your Pastor, Priest Administrator or Pastoral Coordinator stating knowledge and consent of the proposed invitation.

  A testimonial letter from the speaker's religious superior.

  A copy of the speaker’s curriculum vitae or other background information, such as printed publications or websites related to the topic on which the person will be speaking.

Speaker Request Form for Visiting Laity

Speaker/Presenter Information:

Event Information:

Host Contact Information (Requester):