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Please submit your form at least two weeks prior to the event.
Organization:
Contact Information
Preferred date of the event:
Start time:
End time:
Second choice date:
Start time:
End time:
Expected number of attendees:
For presentations for students only, please enter their grade or age:
Location:
Please choose the type of presentation or event you are interested in::
What are the learning outcomes for your event? What are your goals? (OPTIONAL)
Available technology
Other important information about the location (e.g. room layout, available furniture, available materials or supplies, etc.)
Is the hosting organization willing to offer any supplies, materials or reimburse the costs of mileage or supplies? (OPTIONAL)
Special requests or needs:
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