SA-Z Presentation Request Form
What programs are you interested in? Select all that apply.
Please let us know exactly what kind of program you are looking for. We'll work with you to meet your needs.
Required
School/Organization:
Your answer
Name of Contact
Your answer
Contact's E-mail
Your answer
Contact's Phone Number
Your answer
Date(s) for Presentation
If more than one, please note which date you prefer.
Your answer
Length of Presentation & Estimated time of day
(e.g. 6:00 - 7:30pm)
Your answer
What kind of space do we have to work in? (Answer only if it applies to your request.)
Auditorium? Gymnasium? Classroom? Etc. Write N/A if this doesn't apply to your request.
Your answer
What kind of technology is available for the presentation? (Answer only if it applies to your request.)
Individual computers? Projector? Access to internet? Write N/A if this doesn't apply to your request.
Your answer
Who is the target audience for this program?
(Select all that apply.)
Required
What language will be preferred by participant(s)?
(Select all that apply.)
Will parents be present?
How many participants do you expect will attend?
Your answer
What are your expected learning outcomes from the event? What do you want to learn from this program?
(Please list what you would like program participants to learn from this event.)
Your answer
Anything else you would like to share to help us develop the best possible program for you and your organization/school:
Your answer
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