Emergency Management

Disaster Preparedness Group Presentation Request Form

Group Requesting Presentation

Contact Person Full Name

First Name *

Middle Initial

Last Name *

Email *

Phone *

Group Size *

Date of Presentation *

Requested Topic

Requested Presentation Duration (Up to 2 hours)

Requested Location *

Please select the audio-visual equipment you have available for use during the presentation. * Computer or Laptop Projector Projector Screen Sound System

Will audio-visual support be available for assistance, if needed? Yes No

Preferred Method of Contact * Phone Email

Additional Information

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