Speaker or Agency Tour Request - Heart of Illinois United Way

A donation to the Heart of Illinois United Way changes people’s lives, but sometimes it is hard for donors to connect how their gift makes a difference. Hosting a speaker or taking an agency tour can inspire your employees during your workplace fundraising campaign.

The Heart of Illinois United Way can help you arrange your next speaker or tour. Please complete the form below. Requests need to be submitted a minimum of two weeks prior to the date you wish to host a speaker or take a tour.

Please contact if you have any further questions.

Organization Information

Organization Name(Required)

Department / Division / Branch

Organization Contact Name(Required)

First Last

Phone(Required)

Phone Extension

Email(Required)

Organization Address(Required)

Street Address Address Line 2 City State ZIP Code

If you would like to request both a speaker and an agency tour, or request multiple speakers or tours, a separate form will need to be submitted for each request.

Requesting(Required)

Speaker

Agency Tour

Speaker Request Additional Information

The suggested meeting agenda for hosting a speaker should include a welcome message/campaign endorsement, *United Way staff speaker, optional agency guest speaker, and closing remarks.

(*If you are hosting an agency speaker, a Heart of Illinois United Way staff member will also attend to provide brief introduction.)

Speaker Type(Required)

We would like to host a Heart of Illinois United Way Speaker

We would like to host a Heart of Illinois United Way Partner Agency Speaker

Date Speaker is Needed(Required)

To select dates in upcoming months, please navigate to that month using the top arrows or dropdown menu in the date picker. Do not try to select “grayed out” dates.

Time Speaker is Needed(Required)

Speakers will be advised to arrive a minimum of 15 minutes prior to the time listed

Speakers will be joining the meeting(Required)

Virtually

In-Person

Address/Location for In-Person Speaking Engagement(Required)

Street Address Address Line 2 City State ZIP Code

Please share specific parking, entrance, sign-in, safety procedures, etc.(Required)

Please share contact information for someone a speaker can call at the time of meeting if they encounter an issue or need further directions.

Contact Name(Required)

First Last

Contact Phone(Required)

Contact Phone Extension

Contact Email(Required)

If requesting a Partner Agency Speaker, please select three (3) options(Required)

Estimated Audience Size(Required)

Please enter a number greater than or equal to 0.

Speaker Time Limit, in Minutes(Required)

Please enter a number from 5 to 15.

Note(s)

Thank you for requesting a speaker.

You should receive confirmation email for this request form once you click submit.

A Heart of Illinois United Way staff member will follow-up with you within three (3) business days.

Please call us at 309-674-5181 if you have any questions.

Agency Tour Request Additional Information

Date of Requested Tour(Required)

To select dates in upcoming months, please navigate to that month using the top arrows or dropdown menu in the date picker. Do not try to select “grayed out” dates.

Time of Requested Tour(Required)

Please select three (3) options for a Partner Agency Tour.(Required)

Estimated Tour Group Size(Required)