Your Name First: Middle: Last: 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 Choose one from drop-down list Services for Children and Youth New Parks and Recreation Facilities in Your Community Health and Wellness: Recreation Programs and Leisure Opportunities Keeping Your Parks Safe: Working with the Park Police Prince George's County's Rich Cultural History Volunteering and Job Opportunities Preferred length of time for presentation: Choose one from drop-down list 30 minutes 45 minutes 1 Hour Other
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