Presentation Request

2. Camden County, Georgia Presentation Request
6. Your Email Address*
   Please enter your email address for a reply.
8. First Name*
9. Last Name*
11. Group/Affiliation Requesting Presentation
13. Phone Number*
17. I would like a presentation on the following topic:*
    -- Select One --Camden County GovernmentCitizens' AcademySpaceport CamdenStrategic PlanAnother Topic (Details in Comments Section)
19. I would like to request a specific speaker.
21. This presentation will take place (time of day):*
    -- Select One --During Business Hours (8 AM- 5 PM, Monday-Friday)After Business Hours (Weekday)Weekend
23. Location of Presentation
25. Street Address*
27. City*
28. State
29. Zip Code
31. Presentation Requirements*

    Please select ALL items that will need to be brought for the presentation. Additional details may be added below.

    1. Microphone
    2. Projector
    3. Screen

    1. Speakers
    2. Other
35. Presentation Details/Comments
39. While every effort will be made to accommodate your request, resource limitations may prevent accepting all requests.
41. Disclaimer: Information submitted on this form will be sent via email. To protect sensitive information, do not send the following information on this form: Social Security numbers, driver’s license numbers, bank account information, routing numbers, medical information, passport numbers, and passwords.
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43. 1. Receive an email copy of this form.
44. Email address

    This field is not part of the form submission.

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