Request a Speaker

2. Request a Speaker

   Our team is available to speak to community groups of any size on all things disaster preparedness and hazard / threat awareness! It can be as formal as a speaker presentation with slides to as casual as placing and staffing an information table at a community event. How can we support you?

4. Contact Name*

   Name of primary point of contact

5. Contact Phone Number*

   Please provide a 10-digit phone number where we can contact you (xxx-xxx-xxxx).

6. Email Address

   Please provide a valid email address.

8. Topic Request*

   Please provide the topic you'd like us to cover or a brief summary of what we can do to support you so that we can direct your request to the right team member.

10. Location Address for Presentation*

    Where is the presentation to be given?

12. Date, Time and Length of Presentation*
    Date, Time and Length of Presentation Start Date

    Date, Time and Length of Presentation Start Time

    —

    Date, Time and Length of Presentation End Date

    Date, Time and Length of Presentation End Time
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14. 1. Receive an email copy of this form.
15. Email address

    This field is not part of the form submission.

16. Submit

* indicates a required field