Baltimore InterFaith Outreach Council (BIOC)

Our Mission: BIOC is a nonprofit organization established to promote understanding and mutual respect among persons with diverse beliefs through education about Islam and Muslims, discussion, and interfaith interaction.

Speaker Request Form

Full Name:	(required)
Organization/School:
Expected Audience Size:	(required)
Desired Topic: (optional)
Email:	(required)
Work Phone:	Ext.
Home/Cell Phone:	(required)
Speaker/Audience Arrival Time	:     (required)
Date(s) Requested: (MM/DD/YYYY)	/ /  (required) / /  (required)
(ONLY for organizers requesting the presentation be held at their facility)
No. of Class Periods requiring a Speaker	(Non-academic institutions, please leave blank)
Address:
City, State Zip Code:	,
Comments:

Supported by: The Islamic Society of Baltimore (ISB)