Community Historian Program Request
Thank you for your interest in the San Diego History Center's Community Historian Program. Please use this form to request a speaker at your upcoming event, luncheon, or meeting.
Email address *
Requestor's Last Name *
Requestor's First Name *
Phone Number *
Email Address *
Is your group... *
What is the name of your group or organization? *
Number of participants *
Organization street address *
City *
State
Zip Code *
Business phone *
Program choice *
Date *
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DD
/
YYYY
Time *
Time
:
Venue name *
Venue address *
City *
Zip code *
Additional information about venue
Is this program held in conjunction with a business meeting? *
If yes, what are the hours of the business meeting and when do you suggest the presentation start?
How long would you like the speaker to talk? *
Can you provide any of the following equipment? *
Please select all that apply. Our speakers typically arrive about 30 minutes prior to the program start time to set up. Although we typically bring out own laptop and projector, if you can provide any of the additional equipment it would be appreciated.
Required
Any other special requests or concerns?
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