Outreach and Private Group Requests

Name*

First Last

What organization are you with?*

Email*

Phone*

What county are you located in?*

Our grant funding depends on this question, which is why we need to ask.

What city are you located in?*

What type of program are you interested in?*

What adult presentation topic are you most interested in?

What children's presentation topic are you most interested in?

What date is your first choice? (mm/dd/yyyy)*

What date is your second choice?*

What date is your third choice?*

What time of day?*

Number of anticipated guests?*

Do you have a budget to cover a small program fee should there be one?*

Are there any special needs we should know about for your group? (physical or mental limitations, health considerations, etc. - if not, type n/a)