Speaker Request Form If you are interested in requesting a speaker, please fill out the form below and send it to the Oxfam office. Please be aware that the Speaker’s Bureau requires 3 weeks notice to find an available speaker and while we try and send a speaker to most requests, we are not always able to meet requests due to limited resources. Contact Person: __________________________________________________________ Contact number: __________________________________________________________ Email address: Mailing Address: Suburb, State and postcode: __________________________________________________________ Name of Group, Organisation or School: Location of Presentation: __________________________________________________________ Type of Audience: (e.g. High school students, year 10 or Health Care providers) __________________________________________________________ Estimated Number in Audience: __________________________________________________________ Desired Length of Presentation: (e.g. 30 mins) Preferred Date and Time of Presentation: __________________________________________________________ Alternate Date and Time of Presentation: __________________________________________________________ Is your event part of a fundraiser? (If so, please state fundraiser name): __________________________________________________________ Please give a brief description of the event: __________________________________________________________ __________________________________________________________ The Presentation options: (please circle your choice) The standard presentation lasts for 30 minutes and covers an overview of Oxfam Australia’s work and how people can get involved with the agency. If you would like the presentation to focus on a specific area of interest please circle one of the options below but note, we may not always have a specialist available. 1) Oxfam Australia standard presentation 2a) Campaigns – Overview 2b) One of the below GROW (a campaign to create a world where everyone gets enough to eat, always. This campaign has a focus on fixing the broken food system. It includes helping small scale food producers who make up 80% of the world's hungry, addressing climate change, tackling volatile food prices and stopping land-grabs). Close The Gap (a campaign to close the health and life expectancy gap for Aboriginal and Torres Strait Islander Peoples within a generation). Make Poverty History (a campaign to halve global poverty by 2015 based on Australia doing its fair share to achieve the worlds’ agreed plan - the 8 Millennium Development Goals). 3) Oxfam Unwrapped 4) Trail Walker: Annual 100km fundraiser walk for Oxfam held in QLD, NSW, VIC & WA 5) Focus on a specific issue (please note, these requests are harder to fill) o HIV/AIDS o Basic services – Health & Education o Livelihoods o Youth o Emergency response o Fair Trade o Our work in the Field Please return completed form (preferably via email) to: Speaker’s Bureau Oxfam Australia 132 Leicester St, Carlton, VIC 3053 Fax: 03 9347 1983 Ph: 1800 088 110 Email: enquire@oxfam.org.au You will receive an email to notify you that your request has been received. THANK YOU! Office Use Only: First response sent Tracking spreadsheet updated National SRF version 1-January 2014