Request a Speaker | Ohio Consumers' Counsel

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Questions marked with * are required.

Contact Name *

Email Address *

Organization

Street Address

City

County

Zip Code

Telephone Number (with area code)

Preferred Presentation Date(s)

Month

Day

Year

Preferred Presentation Time

Hour

:

Minute

am

pm

Length of Speech

Est. Number of Attendees

May we publicize this event?

Yes

No

Desired Speech Topic

Presentation Location

Presentation City

Zip Code

Presentation Site Phone Number(inc. area code)

Other Relevant Information

Which of the following items can you provide?

Projection Screen

Projector

Microphone