The Ford Story: Guest Speaker Request Form

Ford Speaker Request Form

Welcome to the Ford Speaker Request website. We appreciate your interest in Ford Motor Company.

Please take a few moments to complete and submit the form below. Requests made within a one month window are typically not able to be accommodated due to scheduling constraints. While filling out the form does not guarantee we can provide a speaker, we promise to do our best.

Not sure this where you should be? Visit our Contact Us page for more information.

Please note: Fields marked with an * are required. If not applicable, enter N/A.

Contact Information

Are you a Ford employee or supplier?* Yes No

CDSID if available:

First Name*:

Last Name*:

Company, Organization or Affiliation*:

Professional Title:

Email Address*:

Phone*:

Have you made a request previously?*:
Yes No
Have you made this request through other channels?*:
Yes No

Event Information

Event name*:

Event theme:

Organization or event website*:

Date of event*:

Is this date flexible? Yes No

Event time*:

Confirmation deadline*:

Has a Ford representative ever spoken at your event in the past?*: Yes No

If yes, who has spoken at the event?:

Event Country:

Currently this site is focusing on requests in the United States; however, we will pass your request to the selected region for review.

Event mailing address:

Event city*:

Event state/province*:

Event zip code:

Contact person to coordinate details with:
same as above
different from above

Contact Details

First Name:

Last Name:

Professional Title:

Company or Affiliation:

Mailing Address Line 1:

Mailing Address Line 2:

City:

State/Province:

Zip Code:

Email Address:

Phone:

Event Information
Event type

In regards to Career/Job Fair: At this time we our focusing on speaking engagements. However, we will pass your request to the correct organization.

If other, what type of event:

Why do you want Ford to participate?*:

Audience description*:

Expected audience size:*

Will media be invited?:* Yes No

Please enter a detailed description of the event:

Are there fees required to attend the event?*
Yes No

Speaker Details

Is there a specific person you are requesting? Yes No

If yes, whom?*

If they are not able to attend, would be willing to have a different Ford representative?*
Yes No

What role will the speaker play?

If Other, please describe the role:

Please list additional invited/confirmed speakers*:

Length of expected participation?*

Please indicate materials that will need to be provide (Photo, bio, etc.)*:

Security Challenge

Please type in the letters as you see above: *

Characters are not case sensitive.