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Speakers Bureau Request Form

Please complete the following information. So we may best serve you, we ask that your request be a minimum of two weeks before your event. We look forward to speaking to your community or civic group.

Your Name
First:        

Address

Phone Number

E-mail Address:

Name of organization for whom you are requesting a speaker

Please, briefly state the organization's mission, goals or purpose:

Event for which you are requesting a speaker:

Date and time for which you are requesting a speaker:

Location of meeting/event
Address:

City: Zip Code:

Number of people expected to attend

Topic you are requesting for meeting/event

Preferred length of time for presentation:

     

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M-NCPPC The Maryland-National Capital Park and Planning Commission
Department of Parks and Recreation, Prince George's County
6600 Kenilworth Avenue, Riverdale, MD 20737 • 301-699-CALL (2255)