Speaker Request

Event Sponsor Information

Primary Sponsor*

Primary Sponsor URL*

Primary Sponsor Phone Number*

Primary Sponsor Address*

Country*

Postal / Zip Code

City

State/Province/Region

Event Contact Information

Primary Event Contact*

Title

First

Last

Suffix

Primary Phone Number*

Primary Cell Phone Number*

Email Address*

Secondary Event Contact*

Title

First

Last

Suffix

Phone Number*

Email Address*

Information Disclosure

Each box must be checked to complete the application. By checking each box, you are agreeing to Sandala's speech request terms.

Speech Request Acceptance * NO WARRANTIES OR REPRESENTATIONS REGARDING ACCEPTANCE OF SPEECH REQUEST. Sandala Inc. (“Sandala”) receives a large volume of speech requests and is therefore simply not able to grant all requests. You (“Prospective Host”) understand that Sandala will consider Prospective Host’s request but that Sandala makes no representation that it will be willing or able to accommodate the request. You (“Prospective Host”) agree to receive confirmation from Sandala staff before making any public announcement that Hamza Yusuf ('SPEAKER') will be speaking at or otherwise attending any event planned by Prospective Host. This field is required.

Travel Arrangements * SANDALA NOT RESPONSIBLE FOR TRAVEL ARRANGEMENTS. In the event that Sandala Inc. is willing to fulfill Prospective Host’s request, Prospective Host agrees to coordinate all program and travel details for SPEAKER and SPEAKER’s ASSISTANT with Sandala staff, including all transportation, hotel and meals. This field is required.

Financial Responsibility * Travel arrangements, including transportation, hotel and meals, for SPEAKER and SPEAKER’s ASSISTANT, shall be the financial responsibility of the Prospective Host and must be approved beforehand by Sandala staff for scheduling with SPEAKER and SPEAKER’s ASSISTANT. Prospective Host agrees not to purchase travel or hotel until Prospective Host receives such approval from Sandala staff. This field is required.

Cancellations * SANDALA NOT RESPONSIBLE FOR CANCELLATIONS. Prospective Host agrees and understands that SPEAKER may have to change plans, even at the last minute. Prospective Host shall not hold Sandala or SPEAKER liable for any cancellation for good cause. This field is required.

Honorarium * HONORARIUM BEFORE OR AT EVENT. The honorarium shall be mailed prior to the event or provided at the time of the event unless otherwise specified. This field is required.

Content Ownership * Prospective Host agrees that content of SPEAKER’s presentation shall be the property of SPEAKER and that all copyrights to such content will belong to SPEAKER. Prospective Host agrees not to record, post, distribute without SPEAKER’s express written consent. The views expressed are those of the SPEAKER and not necessarily those of Sandala Inc. This field is required.

Speaker Request

Event Sponsor Information

Event Contact Information

Event Information

Information Disclosure