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Alcoholics Anonymous Ireland
Public Information AA Speaker Request Form
AA’s Public Information (PI) Speaker Service is available to Schools, Colleges, Workplaces etc. AA Members can provide a presentation about Alcoholics Anonymous and the service we provide to those seeking help for an alcohol problem. This service is provided free of charge.
To arrange a booking for AA Speakers, please complete the following details and then submit the completed form. A minimum of three weeks notice is required to secure a booking, but extra notice may be required during busy periods e.g., Easter/Christmas, School Term etc. Talks are generally one hour in duration but can be tailored if required. Final bookings will be passed to the relevant PI Committee who will contact you in due course to finalise the details.
*Please note: School talks are intended only for Transition year students and older. ** Also Note - 3 Weeks Notice Minimum Must Be Given
Requested Date for AA Presentation:
Requested Date for AA Presentation:
DD slash MM slash YYYY
Requested Time for AA Presentation:
Start Time:
Finish Time:
Will the AA Presentation be in person or online? (Please tick the relevant box)
Presentation Type
*
In Person
Online
*How many people will attend? (Approx.)
Number Of People
Approximate age of attendees:
People Age
Gender:
Select Gender
*
Male
Female
Mixed
School/Organisation Name:
School Name
Full postal address (for in person talks):
Postal Address
Eircode (ROI) / Postcode (NI)
Eircode (ROI) / Postcode (NI)
Contact Name:
Contact Name:
*
Contact Telephone No:
Contact Telephone No:
*
Contact Email Address:
Email Address:
List any special requirements:
List any special requirements:
AA's Public Information DVD titled 'The Road Back' can be viewed on our website www.alcoholicsanonymous.ie. Would you like the speakers to show the DVD during the talk? (Please Tick the relevant box)
Public Information
*
Yes
No
Consent
*
I agree to the
privacy policy
.
*