"Supreme Challenge 2016" Speaker Request

The Justice Caucus is pleased to offer highly qualified speakers for community groups and organizations who want to learn more about the 2016 races for the Michigan Supreme Court, the issues, the cases, the candidates and why it matters.

To request a speaker (or even a panel of speakers), please provide the information requested below.

All fields marked with an asterisk (*) are required fields.

Full Name: *

Name of your Group: *

Your Title:

Contact Information

Street Address: *

Bldg/Suite/Apt:

City: *

State: *

Zip Code: *

Phone Number: *

Alt Phone:

Email: *

Event/Meeting Organizer Contact Info

Event Organizer Name:

Event Organizer Phone:

Event Organizer Email:

Event/Meeting Details

Event/Meeting Date: *

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Event/Meeting Start Time: *

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Event/Meeting Duration: *

Unknown

1-2 Hours

2-4 Hours

Over 4 Hours

Facility Details

Facility Name: *

Facility Street Address: *

Facility Bldg/Ste/Apt:

Directions to Facility:

In the text box below type directions to the event from the nearest major road/highway. You can also paste the Web Address (URL) of a set of instructions either from the facility's web site or some other web site such as MapQuest or Google Maps.

Facility City: *

Facility State: *

Facility Zip Code: *

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