Speaker Request Form

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Speaker Request Form

Thank you for contacting Prevent Child Abuse America. Please provide us with as much detail as possible so that we can give your invitation full consideration and respond promptly. Due to scheduling demands, we ask that you make every effort to submit your requests at least 3 months in advance. Pending availability, we may still consider invitations that fall short of this advance notice. Please expect a response to your request within two weeks of receiving it.

Contact Information

Name *

Email *

Phone *

Name of Organization

Organization Website

Event Information

Title of Event

Include link or other information if available.

Speaking Date and Time (including Time Zone)

Event Description

Location of Event

In-Person
Virtual

Format of presentation of speaker request

Audience Profile

Projected Number of Attendees

Presentation Details

Note: Keynote/fireside-chats/panels/webinars will include the following:

- 30-minute planning and preparation call
- 15-minute early check in
- 90-minute presentation

Duration of Presentation

Requested Topic

Please, be specific and include overall goals and outcomes of the discussion/presentation.

Agenda (if created)

Provide any details regarding follow up obligations

i.e., reception, Q & A period.

Include any additional information relevant to the presentation

Pricing Structure

We recognize that smaller, community based, grass-roots organizations may not have the funding to support the fee structure. If this applies to your organization, please contact us at speakerrequests@preventchildabuse.org to discuss your situation further.

If other meetings or things are requested as part of the visit, additional fees will be added.

Speaking fees will be considered donations to PCA America and will help support our work and advance our mission. PCA state chapters and HFA affiliates will receive a 15% discount.

Melissa Merrick, PhD/President and CEO
In person, starting from $7,500 + travel expenses
Virtual $3,500
Jennifer Jones, MSW/Chief Strategy Officer
In person, starting from $5,000 + travel expenses
Virtual $1,500
Bart Klika, MSW,PhD/Chief Research Officer
In person, starting from $5,000 + travel expenses
Virtual $1,500
Other senior leadership across policy, chapters, and HFA departments
In person, starting from $2,500 plus travel expenses
Virtual, $1,000

If you think a child is in immediate danger, call the police at 911.

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Childhelp

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800-4-A-CHILD

Missing & Exploited Children

Have you seen a missing child? Contact the Cybertipline 24-hours a day, 7 days a week. Reports may also be made online at www.cybertipline.com.

800-THE-LOST (843-5678)

National Runaway Safeline

The national communications system for runaway and homeless youth. Call, text, or email for youth crisis intervention. Operates 24 hours a day, 7 days a week. https://www.1800runaway.org/

Speaker Request Form

Contact Information

Event Information

Presentation Details

Pricing Structure

Leave this site safely

If you think a child is in immediate danger, call the police at 911.

findhelp.org Resources

More services

Community Services

Childhelp

Missing & Exploited Children

National Runaway Safeline