The National Excessive Force Institute (NEFI)

Speaker Request Form

The NEFI only accepts Speaker Request Forms from individuals who have Organizational Authority to enter into an agreement with the NEFI.

Thank you for your interest in having a NEFI speaker at your event. In order to help facilitate your request, please complete this online form at least 30 days prior to the event and allow 5-10 business days for decisions to be made. NEFI is a 501 (c) (3) nonprofit and is only able to provide this service as a result of generous donations received from our donors. If you have not received a response within 10 days of your request, you should assume that we are unable to meet your request due to a lack of funding and/or the availability of our speakers.

Contact Information


Coordinator/Point of Contact

Event Location

Audio Video

Will there be a computer projector and screen available
Will there be a means of connecting a computer to external speakers
Will the speakers be sufficient in size for the room
Will there be a microphone available to the speaker
Will there be a floor microphone available to participants for discussion
Will you have a dedicated AV technician available at the event

Event Sponsor(s)

(failure to list every sponsor will result in NEFI not participating)

Event Details

Audience Details



Is membership required to attend
Is there a Cost of Attendance
If yes please provide member and non-member price, if applicable:

Honorable Guest:
(Provide names and titles of all VIP (Imans, Ministers, Pastors, Priest, Mayors, members of Congress, Police Chief’s, college/university Presidents, Civil Rights Leaders, etc.) attending event:
Note: NEFI request that an updated legible VIP list be provided on the day of the event.

Media

Will media be invited
Is the event open or closed Press
Provide and Describe Media List

Notification & Hold Harmless Agreement

By submitting, this form I certify and affirm that I acknowledge that I have read and agreed to the following:
  • Any visual aids and other materials used or provided by NEFI may not be copied or distributed by my organization unless written permission has been received from the NEFI.
  • My organization may be permitted to take still photos during the event. However, due to the content of the presentation provided by NEFI my organization is not permitted to record (sound or visual) any portion of the NEFI presentation without written permission from NEFI.
  • My organization is responsible for safety and security of all participants and attendees at the anticipated event.
  • NEFI may record the presentation on film, tape, disk or other forms of media.
  • NEFI may use the voice, likeness, and biographic or other information of the event attendees in support of its media and/or print campaigns.
  • My organization is responsible for the conduct of the attendees and may provide security if my organization deem security is needed or appropriate.
  • My organization agrees to indemnify, hold harmless, defend, release, and forever discharge the NEFI, its officers, agents, and any person or persons under its direction and control from, and waive any and all responsibility of same, for any and all liability, claim, demands, actions, lost or expense (including costs and attorney’s fees), loss or damage of any kind whatsoever imposed by law upon the NEFI for damages because of bodily injury, including death at any time resulting therefrom, sustained by any person or persons, or on account of damages to property, including loss of use thereof, arising out of or in consequence of the performance of this agreement, provided such injury to persons or damage to property results from and is caused by the negligent or willful acts or omissions of your organization, its officers, agents, employees, or any person or persons under its direct supervision and control.
  • My organization fully understands that my organizations completion of this form does not guarantee that the NEFI will be able to satisfy our request.
I [name of individual] certify and affirm that I have the authority of the [name of organization] to submit this request form/hold harmless agreement to the NEFI.