Survey - National Speaker's Bureau - Speaker Request Form

Medical aid where it is needed most. Independent. Neutral. Impartial.

National Speaker's Bureau - Speaker Request Form

Fill out the form below to request MSF Canada speakers for external events at your organization.

Thank you for your interest in Doctors Without Borders' Speakers' Bureau. Please read through the following information carefully:

We require a minimum of 50 people in attendance for events. Speaker requests will be considered on an individual basis, with special consideration given to events focusing on public and international health, humanitarian affairs & advocacy, and other topics related to the profiles of our volunteers (water and sanitation, human resources, logistics, humanitarian affairs and finance).

Our volunteers are involved in projects around the world and are often in-and-out of the country on short notice. It can, therefore, be difficult for them to commit far in advance to an event. In most circumstances, we will only be able to confirm a speaker up to 2 months prior to the date of your event. With that said, requests should be submitted 1-2 months before the day of the event. Due to volume, requests made less than a month before your event may not be possible to fulfill, and will be considered on a case-by-case basis.

The Speakers' Bureau will contact you within 10 working days of your request to seek clarifications, if required, and confirm whether your request has been deemed appropriate. If so, efforts will be made to identify a speaker, though finding one is not guaranteed.

Requesting an MSF speaker is free; however, we highly encourage donations to MSF Canada by those who have the financial ability to do so.

Should the proposed date, or any other key information for your event, change - or should you decide to cancel the event, you are kindly asked to inform us by emailing us at asso.outreach@toronto.msf.org.

Field Is Required Date of Event

Field Is Required Is this date flexible? If yes, please specify a range during which the event could take place and how much advance notice you need to set the exact date:

Date Range (Maximum response 255 chars, approx. 5 rows of text)

Advance Notice (indicate whether in days or months) (Maximum response 255 chars, approx. 5 rows of text)

Field Is Required Event Time

Field Is Required Time Zone

Field Is Required Event duration (in hours)

Field Is Required Desired Length of MSF Presentation (in minutes)

Field Is Required Is there a definite date at which you need to know the name of the speaker, failing which the request should be considered cancelled?

If yes, please specify the date:

Field Is Required Event location (City and venue) (Maximum response 255 chars, approx. 5 rows of text)

Field Is Required Expected audience size

Field Is Required Event type (For example, panel discussion, keynote, Q&A, etc.)

Field Is Required Will the event be recorded?

Field Is Required What kind of presentation would you like our speaker to do? (For example, PowerPoint, speech, video, etc.) (Maximum response 255 chars, approx. 5 rows of text)

Field Is Required Suggested Topic (please be as specific as possible): (Maximum response 255 chars, approx. 5 rows of text)

Field Is Required Attendance

Field Is Required Will a meal be provided to the speaker? (Maximum response 255 chars, approx. 5 rows of text)

Field Is Required If we are unable to find a speaker who lives in your area, is there a budget to cover transportation costs? (Maximum response 255 chars, approx. 5 rows of text)

Field Is Required Organization Name (Maximum response 255 chars, approx. 5 rows of text)

Field Is Required Contact Person (Maximum response 255 chars, approx. 5 rows of text)

Field Is Required Email (Maximum response 255 chars, approx. 5 rows of text)

Field Is Required Address (Maximum response 255 chars, approx. 5 rows of text)

Field Is Required City

Field Is Required Province / Territory

Field Is Required Postal Code

Field Is Required Work Phone

Field Is Required Home Contact Number

Field Is Required Is a stipend/donation being offered? (Please note that our speakers are not entitled to accept a stipend, except to cover reasonable costs involved with participating in the event. However, we welcome donations to MSF.) (Maximum response 255 chars, approx. 5 rows of text)

Comments

Field Is Required Does this event require proof of vaccine for entry?

DOCTORS WITHOUT BORDERS / MÉDECINS SANS FRONTIÈRES (MSF)

1 800 928-8685 [Toll free]
551 Adelaide Street West, Toronto, Ontario, Canada M5V 0N8
Charitable registration #: 13527 5857 RR0001

ABOUT US

OUR WORK

WORK WITH US

SUPPORT US