Richland County Board of Developmental Disabilities
Richland County Board of Developmental Disabilities
Speaker Request Form
Date of Request:
Name:
Company:
Title:
Phone Number:
Your Email Address:
How did you hear about the Speakers Bureau?:
Event Information
Event Name:
Date of Event:
Time of the Event:
Location/Address of the event:
Is the building wheelchair accessible?
Yes
No
Expected Attendance:
Desired length of presentation:
Desired topic of presentation:
Audio/Visual equipment provided by organization (such as laptop, microphone, TV, DVD player, projector, screen, podium):
Sending Request . . .