Presentation Request Form

Presentation Request Form

If you would like to request a speaker for a program or a classroom visit, please fill out the SMMC Presentation Request Form below. We will try to accommodate all requests, however due to staff limitations, requests may have to be filled on a first come first serve basis.

A representative from the SMMC should contact you within 48 hours of receiving the request. Please allow two weeks advance notice for speaker requests when possible.

 

Requester Information:

First Name:

Last Name:

E-mail Address:

Telephone Number:

Organization/Group:

Presentation Information:

Topic:

If other, please specify the topic:

Presentation Date:

Presentation Time: A.M. or P.M. to A.M. or P.M

Presentation Location:

Presentation Type: PowerPoint Interactive Activity

If PowerPoint, please provide the following information:

Laptop Provided*:

Projector Provided*:

Target size of group:

Other Comments/Requests for the presentation:


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