Campaign Speaker/Experience/Fair Request Form

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To ensure we are able to accommodate your request, please submit this 2-3 weeks before the desired start date of your campaign.

Company Name

Engagement Leader Name

Engagement Leader Email Address

Engagement Leader Phone Number

Type of Request (choose all that apply)

Impact SpeakerImpact Fair (a UWGC representative will reach out to you to finalize the details)Impact Experience

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Other

What is the meeting format?

In PersonVirtual/OnlineHybrid

Brief description of the agenda (e.g. who will be speaking, audience, etc.)

How much time does your agenda allocate for your United Way speaker?

Event Date

Event Start Time

Upload an Agenda (optional)

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Impact Experience

Which Impact Experience would you like? (choose all that apply)

Ready Kids Ups & Downs: In-person, UWGC-facilitated activity (ideal for 5-6 participants plus observers)Housing First Navigation: In-person, UWGC-facilitated activity (ideal for 2-3 participants plus observers)United Way 211-Help is only a call away: In-person, self-service activity (no limit on number of participantsVolunteering with United Way: In-person, UWGC-facilitated activity (no limit on number of participants)

You plan to utilize the UWGC Impact Experience as a:

Kickoff ActivityStandalone Event (e.g. Young Professionals or Leadership event)Other (please specify)

Please describe "Other"

How many people do you estimate will participate in the event?

How much time is allotted for this event?

Event Date

MM/DD/YYYY

Event Start Time

##:## AM or PM

Provide a brief description of the agenda (speaker(s), audience, etc.)

Please provide any other relevant event details

If applicable, please upload a photo of the event space.

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Impact Fair

Which Impact Experience would you like to be part of your Impact Fair? (choose all that apply)

Ready Kids Ups & Downs: In-person, UWGC-facilitated activity (ideal for 5-6 participants plus observers)Housing First Navigation: In-person, UWGC-facilitated activity (ideal for 2-3 participants plus observers)United Way 211-Help is only a call away: In-person, self-service activity (no limit on number of participantsVolunteering Expo: In-person, UWGC-facilitated activity (no limit on number of participants)

You plan to utilize the UWGC Impact Experience as a:

Kickoff ActivityStandalone Event (e.g. Young Professionals or Leadership event)Other (please specify)

Please describe "Other"

How many people do you estimate will participate in the event?

How much time is allotted for this event?

Event Date

MM/DD/YYYY

Event Start Time

##:## AM or PM

Provide a brief description of the agenda (speaker(s), audience, etc.)

Please provide any other relevant event details

If applicable, please upload a photo of the event space.