Florida Speaker Bureau Request Form

Organization Telephone (with area code):

Requested Date (at least two weeks lead time):

Total Number of Attendees (Must be at least 30 people):

Please note: You will be contacted by our volunteer Speakers Bureau coordinator for confirmation. You must cancel if your audience drops below 30 people for any reason.

Speaking Engagement Address

Street address for the location of the speaking engagement:

City:

State:
FLORIDA

Zip:

Daytime Telephone (with area code):

Specific Topic of Interest (Please Indicate Up To Four)
Consumer Fraud (Identity Theft, Top Frauds, Investment Scams or Home Improvement Tips)
Medicaid Long-Term Care
Medicare Part D
Social Security
AARP General
AARP Legislative Issues
AARP Drivers Safety Program
AARP Tax Aid
Other

Please allow two weeks advance notice to schedule a speaker and for planning purposes.