STATE OF NEW JERSEY | COUNTY OF BERGEN
               

Bias Crimes Presentation Request

Bias Crimes Presentation Request Form
Address of Presentation:
Address of Presentation:
City
State/Province
Zip/Postal
Time of Presentation:

*PLEASE NOTE: All presentations for 2023 dates have been booked. Please request a presentation date starting in January 2024. 

Your Name:
Your Name:
First
Last

As the requesting organization, I hereby submit this form indicating our interest in hosting a presentation. I acknowledge that this information will then be distributed to the Speakers Bureau of the Bias Crimes Unit. If the Bias Crimes Unit can accommodate my request, I will be notified at the contact information provided. A mutually agreeable date and time will then be confirmed. 

Agreement to Terms:

Upon completion of this form, press submit, which verifies your understanding, agreement and compliance with all guidelines established herein.