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Speaker/Vendor Table Request
Today's Date: Wednesday June 7, 2023
*Date of Event:
Three-weeks advance notice required

*Requesting Organization:
*Contact Name:
*Contact Phone: (ex: 555-555-5555)
Contact Fax: (ex: 555-555-5555)
*Contact Email Address:
Name of Program/Event:
*Type of Event:
*Location Name of Event: (ex: Church, business, library, etc.)
Location Type: (ex: Auditorium, Board Room, Cafeteria, etc)
*Location Address:
*Location Zip Code:
*Event Start Time:          *Event End Time:
Allotted Time for Speaker:
Event Open to the Public? Yes      No
Items Provided by Requester:
Table/Chairs Canopy Tent
Projector/Screen Other
*Available Topics: (Maximum of two topics)
Careers Utility Safety Credit Policy/Establishing Service
Outages/Reliability My Account Energy Conservation Principles
EcoBUILD Senior Programs Special Assistance Programs
Gas Purchasing The Terminator* Careers-on-Wheels*
Water Quality Customer Service Energy Smart Workshop**
Smart Meters Gas Principles Electricity Generation/Distribution
Energy Efficiency Ord. Financial Literacy Senior Bingo
Pumping Station Tour* Conservation Girl* Kids Energy Conservation Workshop**
*Limited to school groups
**Please allow one hour
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      Social Media      Other