Mazzoni Center's Anti-Stigma Campaign: Call For Speakers

Thank you for your interest in being a speaker for Mazzoni Center's Anti-Stigma Campaign. The deadline to submit a proposal is June 14th. Speakers will be notified if they have been selected by July 24th.

We will choose 4 speakers to share their personal experiences related to PrEP, HIV, and navigating stigma at our Take Back Your Health Event on August 22nd in Center City (location TBD).

An honorarium of $500 is available for all selected speakers.
Please contact education@mazzonicenter.org with any questions.

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* 1. Please enter your contact information

First Name

Last Name

Pronouns

Email Address

Phone Number

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* 2. Please enter your demographic information. Demographic information is optional and will not be used to determine artist selection.

Age

Gender Identity

Sexual Orientation

Race

Professional Title & Affiliated Organization (if applicable)

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* 3. Do you identify as any of the following? Check all that apply.
** Not identifying with any of these does not automatically disqualify you. We ask this because these are our priority populations for this project.

BIPOC

Youth (19-24 years old)

MSM (men who have sex with men)

Trans woman

None of the above

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* 4. Do you have lived experience with any of the following? Please check all that apply.
**We ask this because this is the topic we are asking folks to speak on. Any information you share here, will only be seen by Mazzoni staff members that are involved in the selection of speakers.

Living with HIV

Being at risk of HIV

Taking Long-Acting Injectable (LAI) PrEP

Taking Oral PrEP

Taking PEP

Other (please specify)

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* 5. If you would like to share more about your above answer, or other aspects of your personal identity, please do so here.
(Ex. I was born and raised in Philadelphia, I am a queer South Asian person who is HIV positive)

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* 6. Would you be able to have your speech on the topic of PrEP, HIV, and navigating stigma, completed by August 3rd to be reviewed by Mazzoni Center Staff?

Yes

Other (please specify)

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* 7. Do you have prior public speaking experience?

Little to None

A lot

Clear

i We adjusted the number you entered based on the slider’s scale.

Mazzoni Center's Anti-Stigma Campaign: Call For Speakers

Question Title

* 1. Please enter your contact information

Question Title

* 2. Please enter your demographic information. Demographic information is optional and will not be used to determine artist selection.

Question Title

* 3. Do you identify as any of the following? Check all that apply.
** Not identifying with any of these does not automatically disqualify you. We ask this because these are our priority populations for this project.

Question Title

* 4. Do you have lived experience with any of the following? Please check all that apply.
**We ask this because this is the topic we are asking folks to speak on. Any information you share here, will only be seen by Mazzoni staff members that are involved in the selection of speakers.

Question Title

* 5. If you would like to share more about your above answer, or other aspects of your personal identity, please do so here.
(Ex. I was born and raised in Philadelphia, I am a queer South Asian person who is HIV positive)

Question Title

* 6. Would you be able to have your speech on the topic of PrEP, HIV, and navigating stigma, completed by August 3rd to be reviewed by Mazzoni Center Staff?

Question Title

* 7. Do you have prior public speaking experience?

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* 8. Please share more about your prior experience here

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* 9. Do you have any barriers to attending the Take Back Your Health event on August 22nd in Center City (location TBD), to give the speech?

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* 10. In 3-5 sentences, why do you want to be selected or what makes you a good fit to be a speaker for this event?

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* 11. Please share your bio here (4-6 sentences)
*If you are selected, your bio will be read to introduce you at the event

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* 12. Do you have any accessibility needs that we should know of?
For the day of the event and leading up to it.

Mazzoni Center's Anti-Stigma Campaign: Call For Speakers

Question Title

* 1. Please enter your contact information

Question Title

* 2. Please enter your demographic information. Demographic information is optional and will not be used to determine artist selection.

Question Title

* 3. Do you identify as any of the following? Check all that apply.** Not identifying with any of these does not automatically disqualify you. We ask this because these are our priority populations for this project.

Question Title

* 4. Do you have lived experience with any of the following? Please check all that apply. **We ask this because this is the topic we are asking folks to speak on. Any information you share here, will only be seen by Mazzoni staff members that are involved in the selection of speakers.

Question Title

* 5. If you would like to share more about your above answer, or other aspects of your personal identity, please do so here. (Ex. I was born and raised in Philadelphia, I am a queer South Asian person who is HIV positive)

Question Title

* 6. Would you be able to have your speech on the topic of PrEP, HIV, and navigating stigma, completed by August 3rd to be reviewed by Mazzoni Center Staff?

Question Title

* 7. Do you have prior public speaking experience?

Question Title

* 8. Please share more about your prior experience here

Question Title

* 9. Do you have any barriers to attending the Take Back Your Health event on August 22nd in Center City (location TBD), to give the speech?

Question Title

* 10. In 3-5 sentences, why do you want to be selected or what makes you a good fit to be a speaker for this event?

Question Title

* 11. Please share your bio here (4-6 sentences)*If you are selected, your bio will be read to introduce you at the event

Question Title

* 12. Do you have any accessibility needs that we should know of? For the day of the event and leading up to it.

* 3. Do you identify as any of the following? Check all that apply.
** Not identifying with any of these does not automatically disqualify you. We ask this because these are our priority populations for this project.

* 4. Do you have lived experience with any of the following? Please check all that apply.
**We ask this because this is the topic we are asking folks to speak on. Any information you share here, will only be seen by Mazzoni staff members that are involved in the selection of speakers.

* 5. If you would like to share more about your above answer, or other aspects of your personal identity, please do so here.
(Ex. I was born and raised in Philadelphia, I am a queer South Asian person who is HIV positive)

* 11. Please share your bio here (4-6 sentences)
*If you are selected, your bio will be read to introduce you at the event

* 12. Do you have any accessibility needs that we should know of?
For the day of the event and leading up to it.