Speakers Bureau Request Form Please enable JavaScript in your browser to complete this form.The Friends of the Elephant Seal Speakers Bureau schedules speaking engagements with various organizations, clubs, libraries and venues. Please complete this form and our Coordinator will contact you within 3 business days We are grateful for your support and for giving us the opportunity to offer this special experience for your group. Program Name or ID NumberBusiness or Organization NameAddress of Presentation VenueAddress Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeCoordinator Contact Info *FirstLastEmail *PhoneLeader in Charge on Day of Presentation *FirstLastMobile PhoneSchedule Your PresentationPlease schedule your presentation at least five weeks in advance. Please list three possible dates for your presentation. (in order) 1st Choice Date / TimeDateTime2nd Choice Date / TimeDateTime3rd Choice Date / TimeDateTimeExpected length of presentation?Audience size?Age Group(s) of Audience? check all that apply)Children age 6-12Teens age 13-17Adults age 18-65Seniors >age 65Projection Equipment available at the location: *LED screen TV with HDMILCD projectorProjection screenNo screen or projector (Please bring both)Microphone and sound systemNo microphone or sound system neededWill you advertise the event to the public? *YesNoIf YES, please explain plans for advance publicityAny other details you would like to tell us about?CommentSubmit
