Awareness Presentation Registration
Please review RLR's guidelines to help determine whether an in-person or virtual program will be more effective: https://bit.ly/rlrcvguidelines.

Use THIS form for in-person presentations and trainings.
Digital Programs for schools can be requested through this from: bit.ly/digitalprogramregistration.
Virtual Trainings for community agencies can be requested through this form: bit.ly/virtualtrainingregistration
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Which Awareness Campaign(s) are you registering for? *
Required
Personal Information
Name (first & last) *
Title/Position *
Grade (if student or teacher)
Email *
Phone Number (please put the number that is easiest to contact you) *
How do you prefer being contacted? *
How are you registering? *
Are you requesting this to be an in-person presentation or a virtual presentation? *
Organization/School Info
If this is a virtual presentation, disregard questions pertaining to a physical location.
Name *
Address (Street, City, State, Zip Code) *
Website *
Phone
Event Details
Requested date(s) for campaign: *
(mm/dd/yy)  
Requested time for campaign: *
specific time (ex: 11:30am-12:45pm), half-day (morning), half-day (evening), full-day, etc.
Suggested arrival time:
It typically takes a minimum of 30 minutes for set up, technology run through, sound check, etc.
Is the presentation location the same as the address given above? *
If not, please provide the address (street, city, state, zip code) of the presentation location.
Additional location details: *
If applicable: building number/name, room number, parking instructions, etc.
Estimated length of presentation: *
Note: our most basic presentation for youth lasts approximately 50-60 minutes, and for adults 60-90 minutes.
How many presentations are being requested? *
Estimated number of people in attendance: *
Will there be proper equipment for presentation media? (i.e. overhead projector, computer, speakers, access to digital platform, etc.) *
If so, please select the equipment that will be provided:
Brief description of requested event: *
Additional comments:
If your request is for an in-person presentation, please include as many details as possible about social distancing and other health policies your venue/agency is implementing. RLR's guidelines will also help determine whether an in-person or virtual program will be more effective: https://bit.ly/rlrcvguidelines.
Thank you for registering for an awareness presentation! Here are some next steps you can expect after submitting this request:

-- We will contact you within a week of your submission to confirm your registration and begin the planning process.
-- After all logistics are confirmed and dates are set, we will send you a Confirmation Letter that includes all the details of your presentation, as well as expectation and preparation details for your review.

We are excited to fight for freedom with you. Welcome to the Rebellion!
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