Forms • Mount Pleasant, SC • CivicEngage

Emergency Manager Speaker Request

Leave This Blank:

Name of Organization *

Location *

Date of Presentation *

Presentation Length (time)*

Topic Requested *

Number of Persons Attending*

Do you have audio visual equipment available for the speaker to use, if needed?

Computer

Yes

Projector with Computer Input

Yes

Screen

Yes

Contact Information

Name*

Address*

City *

State*

Zip*

Email *

Phone*

Comments

* indicates required fields.