Tuskegee Airmen, Inc., Los Angeles Chapter

Request for Speaking Engagement

Please print the form and mail to:

Simeon B. Ginyard, Sr.
10252 3rd Avenue
Inglewood, CA 90303
(323) 901-1959

Name of person making request:	First: Last:
Name of organization making request:
Requester's office phone:
Requester's office fax:
Organization's mailing address:
Address Presentation to take place:
Number of people in attendance:
Age group of people at presentation:
Date of presentation:
Start time:
Will honorarium be donated?:
Message:

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