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Speakers Bureau Request Form

Please fill out the form below to request a speaker from the MCSW Speakers Bureau. Speakers are free of charge. However, tax-deductible donations to the MCSW are always welcomed to help subsidize MCSW's operating and special project expenses.

Name/Contact Person:   

Title:   

Organization:    

Address:   

Phone:   

Fax:   

E-mail Address:   

Speaker You Are Requesting: (First Choice)   

(Second Choice)   

Date of Event:   

Time of Event:   

Location of Event/Meeting, including room number and zip code:   

Number of Attendees Expected:   

Topic to be Discussed:   

Description of Event   

Additional Requests or comments:   

   

   

You can also submit your request via E-mail, Fax, or U.S. Mail.

  • E-mail: mcsw@state.ma.us
  • Fax: (617) 626-6530
  • U.S. Mail:
        Massachusetts Commission on the Status of Women

        Charles F. Hurley Bldg.
        19 Staniford St., 6th FL
        Boston, MA 02114.





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    19 Staniford St., 6th Fl. Boston, MA 02114 Phone: 617-626-6520 Fax: 617-626-6530