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Please provide the following information for each request:

  • Requested topic(s) - prioritized, if more than one choice

  • Brief description of the event or program

  • Dates, times and length of presentation - provide options, if possible

  • Number of times the presentation is to be given

  • Description of audience and estimated number of attendees

  • Location of the presentation - include county

  • Directions to the location of the presentation

  • Contact person - include work or home address,
        work and home phone numbers, and an e-mail address

  • Thank you. Please submit the completed request form to:

    Marc Rogoff
    Speakers Program Coordinator

    Phone: 609-292-1474