Invite Us Thank you for your interest in inviting NETWORK to speak or do a workshop for your organization. Please note: this form is NOT for media requests; please contact our media team to set-up an interview with Sister Simone. Type of Event requested:*Simone Speaking EngagementWorkshop hosted by NETWORK staffWant to learn more about NETWORK, our issues, or how to be an effective advocate for justice? Whether you have an hour or a whole day, the NETWORK Advocates team can work with your group to provide tailored workshops and trainings that will equip you to be powerful leaders in the global movement for social justice.● There is a suggested donation of $100-$500 depending on the length of the workshop, although we are always happy to work with your group’s budget. ● If travel is required, we ask that the costs of travel and accommodation be provided. ● As we sometimes have many requests coming in, please submit your request at least 30 days prior to the requested dates of the workshop. Thank you and we look forward to sharing our knowledge and experience with you in pursuit of the common good!About youName of requesting group or organization:*Website:Are you located in the United States or Canada?*YesNoOrganization or Group Address:* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State / Province ZIP Code Organization or Group Address:* Street Address Address Line 2 City State / Province / Region AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Name of requesting individual* First Last Email and Phone*EmailEmail* Phone*Phone Contact Person if different than requesting individual:Please include name, email, and phone numbers of the person who we will work with on details of this request. First Last EmailPhoneEvent DetailsEvent Name:*Event Location* Street Address Address Line 2 City State/ Province ZIP / Postal Code Please describe the event's purpose and desired outcome:*Event Start Date* Event End Date* Event Start Time* : HH MM AM PM Event End Time* : HH MM AM PM Is this date and/or time flexible?*YesNoPlease indicate in detail what alternative times or dates are available:What is the title, topic or theme of Sister Simone's part of your event?*Please describe Sister Simone's role at your event:*Keynote, Major AddressPanel, DiscussionSermonWorkshop or Retreat LeaderAward RecipientSmall Group ParticipantBook Reading or SigningOtherPlease explain in detail Sister Simone's role:*Is Sister Simone's participation at more than one time?*YesNoStart of Simone's portion:* : HH MM AM PM End of Simone's portion:* : HH MM AM PM Start of second portion: : HH MM AM PM End of second portion: : HH MM AM PM Start of third portion: : HH MM AM PM End of third portion: : HH MM AM PM If Sister Simone is unavailable would you be interested in having another representative from NETWORK be part of your event?*YesNoUnsureIs the event open to the public?*YesNoIs there a cost to attend?*YesNoWhat is the ticket price?*Is this event a fundraiser?*YesNoFor whom?Anticipated Audience Size:*Audience and key participants:* Academic including teachers and students Religious Elected Officials Business Leaders Other Please describe the diversity of the audience including age, religious affiliation, and racial and ethnic makeup:*May NETWORK connect with the attendees after the event?*Yes, we will give NETWORK attendee contact information.Yes, we will send an email to attendees on NETWORK's behalf.Yes, we will provide information about connecting with NETWORK in an organization publication.No, there is not a way to connect with attendees or our community after the event.In addition, are you willing to? (check all that apply) Include NETWORK materials in attendee handouts Provide a table to display NETWORK materials What is the closest airport or train station?*Can you reimburse for travel expenses?*We request reimbursement for all travel expenses. NETWORK will book travel and submit receipts/invoice for you to reimburse. Indicate here if you are unable to do this.YesNoHonorarium:*Honoraria for Sister Simone engagements typically range from $2,500 for smaller organizations to $10,000 for larger organizations; however, we do not want cost to be a deterrent and will do our best to work within your budget.When do you need a decision by?* Desired location:*NETWORK OfficesRequested Date:* Is this date flexible?*YesNoPlease indicate in detail what alternative times or dates are available:*Is there a particular topic you are interested in? About NETWORK Catholic Social Justice Faith-Based Advocacy (Overview) How to Lobby / Prep for a Lobby Visit Mend the Gap Policy Briefing Racial Wealth and Income Gap Town Hall for Tax Justice Transformative Conversations Wealth/Income Inequality Other Indicate "Other" topic here:*Are you planning on visiting your members of Congress on Capitol Hill or in-district soon after this training?* On the Hill Home district No Are you looking for assistance to set up the lobby meetings?* Yes No For the policy briefing or lobby visit, what topic(s) would you like to focus on?* Tax Justice Living Wage / Family-Friendly Workplaces Healthcare Immigration Democracy/Voting Rights/Census Housing Other Anticipated Audience Size:*Please describe the diversity of the audience including age, religious affiliation, and racial and ethnic makeup:*If travel is required will you be able to cover the cost?*YesNoDonation/Honorarium amount:*Tell us a bit more about what you hope to gain from a NETWORK training or workshop?*Is there anything else you think we should know?