Request a St James Infirmary Speaker

A St James Infirmary Speakers Bureau representative will review your request and contact you. Please note all requests will take up to 2 weeks to process, so please plan your event accordingly. If a response to your request is not within 30 day of your initial request date, please contact Kalash Ka Fae, CMT, MSW, ELC at

* 4. Date of Presentation:

* 7. Audiovisual Capabilities (please provide special notes and instructions)

* 11. Host Organization Web Address:

* 12. Host Organization Address

* 13. Host Organization Mailing Address (if different from above):

* 14. Name and Pronoun of Host Contact Person (how do you gender identify?; i.e.: she, he, they, first person, etc.):

* 15. Email Address:

* 16. Day/Evening Time Phone Number:

* 17. Best times to call:
(please include your global time zone)

* 18. Event Address

* 19. Objective/Theme of Event:

* 20. Agenda
Please copy and paste agenda into space below.
(if applicable)

* 21. Additional information about your event you would like to share: