Your Email*
Organization Name*
Contact Name*
Phone Number
Event Name*
Event Date*
Event Time*
Requested Speaker*
If you have a specific person in mind, please enter their name here. If not, please indicate the topics you'd like the individual to speak on.
Speaker Format*—Please choose an option—KeynotePanelRallyTraining/WorkshopPodcastLive interviewInformal Q&A
Is this event virtual or in-person?*—Please choose an option—VirtualIn-Person
Event Description*
Who is the primary audience of this event?*
Approximately how many attendees are you anticipating?*
Do your target audiences include any of the following groups?*
Select all that apply. (Note: Please ONLY check those groups who are your primary participants, not simply groups who are welcome to join. For example, a climate change conference may be open to BIPOC individuals, but unless it is an explicitly Black-centered event, "Black people" should not be selected.)
Gulf South residentsU.S. South residentsGlobal South residentsClimate justice activistsBlack peopleIndigenous peopleImmigrants & RefugeesLGBTQIA+ peopleEnvironmental activists and organizersGovernment officials
Is there a registration fee for participants at this event? If so, please enter it here.*
If there are multiple fees, you can also enter a link to the registration page.
Will the event be live-streamed online?*—Please choose an option—Yes, it will be publicly streamedYes, it will be privately streamedNo, it will not be streamedOther
Will the event be recorded?*—Please choose an option—YesNo
Will language interpreters be provided?*
If so, please list the languages.
Will the event be captioned?*—Please choose an option—YesNo
Does this engagement provide an honorarium?*—Please choose an option—YesNo
May Taproot receive a copy of the recording?*—Please choose an option—YesNoN/A
May Taproot have access to the participant list, including email addresses?*—Please choose an option—YesNoOther
Is there an opportunity for Taproot to co-brand this event?*—Please choose an option—YesNoOther
Anything else?
Please use this space to share anything else you'd like us to know about the event.
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