Speakers Bureau Request Form | Friends of the Elephant Seal

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 Number

Business or Organization Name

Address of Presentation Venue

Address Line 1

Address Line 2

City

State

Zip Code

Coordinator Contact Info *

First

Last

Email *

Phone

Leader in Charge on Day of Presentation *

First

Last

Mobile Phone

Schedule Your Presentation

Please schedule your presentation at least five weeks in advance. Please list three possible dates for your presentation. (in order)

1st Choice Date / Time

Date

Time

2nd Choice Date / Time

Date

Time

3rd Choice Date / Time

Date

Time

Expected length of presentation?

Audience size?

Age Group(s) of Audience? check all that apply)

Children age 6-12
Teens age 13-17
Adults age 18-65
Seniors >age 65

Projection Equipment available at the location: *

Will you advertise the event to the public? *

Yes
No

If YES, please explain plans for advance publicity

Any other details you would like to tell us about?