Ayn Rand Speaker Request Use this form to request an ARI speaker visit your campus or classroom in person or by videoconference. Question Title * 1. Contact Information Title: Name: College/University: Field: City: State: -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming Zip/Postal Code: Country (if not US): Email Address: Phone Number: Question Title * 2. What type of event are you planning/considering? (Check all that apply.) Debate Lecture Panel Virtual visit (by videoconference) Other (please specify) Question Title * 3. What are your financial needs for the speaker visit? (Please elaborate in the space provided.) No support from ARI will likely be necessary Partial support from ARI will likely be necessary Full support from ARI is needed N/A -- Requesting visit by phone or videoconference (no travel costs; honorarium waived) Please elaborate Question Title * 4. Are you currently receiving funding from another source for activities which may overlap with the intent of this offer? No | N/A (no funding needed) Yes | Maybe -- please elaborate and we'll contact you to discuss eligibility for funding Question Title * 5. What topics are you interested in? (Check all that apply.) Objectivism/Philosophy Ayn Rand’s Novels Nature of Government Morality of Capitalism Income Inequality The Welfare State/Entitlements Cronyism Rule of Law Free Speech Campaign Financing Environmentalism Health Care Religion and Morality Foreign Policy Other (please specify) Question Title * 6. Indicate other (potential) participants in the event, if applicable Question Title * 7. Will the event be open to the public? Yes No Please elaborate if needed Question Title * 8. Expected size of audience? Under 50 50-100 100-150 Over 150 Question Title * 9. For in-person campus visits, what additional activities could the speaker participate in to maximize the value of the visit? (e.g., classroom talk, private faculty meeting, etc.) Question Title * 10. Provide a time frame for the visit and indicate whether your schedule allows flexibility. Question Title * 11. Have you hosted an ARI speaker in the past? Yes No If yes, please provide details: Question Title * 12. Use this space to provide any additional information that could help us evaluate your request Question Title * 13. I Agree to Ayn Rand Institute's Privacy Policy and Terms & Conditions of Service. Yes Click "Done" to submit your request. By submitting this form, you agree to receive future emails from ARI about this request and relevant promotions. You may opt-out at anytime from promotional emails. Done