CDF Event Participation
Request Form
for Rev. Dr. Starsky Wilson

Please provide as much detail as possible.

Date of Submission*
MM slash DD slash YYYY
Date of Event*
Event's Beginning and Ending Time, Please Include Time Zone*
Nature of Request*

(meeting presentation, keynote speaker, panelist, moderator, award recipient, preacher, other)
Requested Arrival Time*
Name of Host Institution*
Name and/or Theme*
Topic and/or Agenda*
Anticipated Outcome*
Time Keynote/Address/Sermon will begin*
Requested Length of Presentation*

(e.g. 20 min. remarks)
Please provide a detailed description of requested subject matter. List any key points or issues you would like to be addressed.*
Please list additional speakers/panelists on the program, if applicable.*
Anticipated audience*

(i.e. projected attendance, affiliations, demographics)
Will press be present at event? If so, please list:*
Event Location with address*
Recommended attire*
Name of person submitting request*
Contact email*
Daytime cell phone contact number*
Name of contact person for logistics*
Contact email*
Name of contact person for content*
Contact email*
Will an honorarium be provided? If yes, please provide offer amount.*

(Note: Acceptance of an invitation is not based on the host's ability to pay.)
Provisions of accommodations, if lodging is required outside of the Washington, DC region.*
Provisions of travel expenses, if travel is required outside of the Washington, DC region.*

(i.e. flight, ground transportation, meals etc.)
Will the event be streamed live OR will a recording be available online?*
- Yes
- No
Please specify which (streamed live or recording available online):
Please provide a link to where the live event or recording will be available:
Will there be a cost associated with viewing the event?
If you would like us to promote Rev. Dr. Wilson’s participation in the event, please provide a link to a 1600 x 900px graphic that we can use on our social channels (optional):
Accepted file types: jpg, gif, png, Max. file size: 200 MB.
Name and email address for point of contact to coordinate promotion, if necessary.
Phone
This field is for validation purposes and should be left unchanged.

CDF Event Participation Request Form for Rev. Dr. Starsky Wilson

Please provide as much detail as possible.

Be a champion for all children.

CDF Event Participation
Request Form
for Rev. Dr. Starsky Wilson