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Public Education Program - Online Speaker Request Form
Today's Date:
Thursday July 29, 2010
*Date of Event:
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2010
2011
Three-weeks advance notice required
*Requesting Organization:
*Contact Name:
*Contact Phone:
(ex: 555-555-5555)
Contact Fax:
(ex: 555-555-5555)
*Contact Email Address:
*Location Name of Event:
(ex: Church, business, library, etc.)
Location Type:
(ex: Auditorium, Board Room, Cafeteria, etc)
*Location Address:
*Location Zip Code:
*Time of Event:
Allotted Time for Speaker:
*Available Topics: (Maximum of two topics, Please allow 1 1/2 hours for the presentation)
Careers
Utility Safety
Credit Policy/Establishing Service
Outages
Meter Reading
Energy Conservation Principles
EcoBUILD
Senior Programs
Special Assistance Programs
Gas Purchasing
The Terminator*
Careers-on-Wheels*
Water Quality
Customer Service
Energy Smart Workshop
Memphis Water
Gas Principles
Electricity Generation/Distribution
Energy Efficiency Ord.
Smart Grid
*
Limited to school groups
Event Phone:
(ex: 555-555-5555)
Event Contact Person:
Est. Number of Attendees:
Total
Adults
Seniors
Children
Children's Ages/Grade Levels:
Other Details:
How did you find the Speaker's Bureau? (Check all that apply)
MLGW Website
Previous Speakers
MLGW Publication
Other
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