Request a Program


Due to the high volume of requests our office receives for programming, we ask for a 2-week notice on requested program dates.

Contact Information
Name: A value is required.
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Phone: A value is required.
Preferred to Contact by: Email Phone Either
   
Audience
Audience Description: Please select a valid item.Please select an item.
Audience Gender: Male Female Other
Audience Age/School Year: A value is required.
Expected Attendance: A value is required.
Organization/Class Name: A value is required.
   
Event
Requested Topic: A value is required.
Event Name: A value is required.
Location of Program: A value is required.
Preferred Date: A value is required.
Preferred Time: A value is required.
Alternate Date: A value is required.
Alternate Time: A value is required.
   
Other
Comments: A value is required.
Requested Presenter: Please select a valid item. Please select an item.
Equipment Available at Location: Computer
LCD Projector
Overhead Projector
Projection Screen
Ethernet
Wireless
TV/VCR
TV/DVD Player
Paper & Easel
Dry Erase BoardMinimum number of selections not met.Maximum number of selections exceeded.

Types of Advertisements:

Flyers/Posters
Voicemail
Banner
Internet
Handbill
Other:
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