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CEO Request Form

Thank you for your interest in setting up a meeting or inviting DeAngela Burns-Wallace, Ed.D., president and chief executive officer of the Ewing Marion Kauffman Foundation, to attend your event. Please fill out the form below, and we will be in contact with you shortly.

For general inquiries, media inquiries, or to request Dr. Burns-Wallace or any Kauffman associate to speak at your next conference or event, please complete the form on our Contact page.

For inquiries relating to funding opportunities, please visit our funding section to learn more.

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What best describes the nature of this request? *
Are you submitting this on behalf of someone?
Enter your contact information:
Who is this request on behalf of?
Enter your contact information:
What is the purpose of the meeting? *
What are you hoping to discuss? (e.g. agenda, list of topics/questions) *
Please select your desired meeting location. *
What is the date of the event? (YYYY-MM-DD)
What time is the event?
Please include the time zone (AST, EST, CST, MST, PST, AKST, HST, UTC-11, or UTC+10
Where will the event be located?
Please provide a description of the event, or a link to the website if available.
Has your organization received funding from the Kauffman Foundation in the past? If yes, please describe.
Do you plan to make a funding request?*
Please list the name(s) of any Kauffman associates you have worked with previously (e.g. Program Officer).
I agree that the Foundation may use my personal information to communicate with me about the Foundation and programs I may find interesting, to personalize my experience on Foundation web sites, conduct academic/charitable research, collect data about me from other sources, and share my data with trusted Foundation affiliates. Please review our privacy policy which provides info on how we use, process, and protect your data.*