Full Name
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Company/Organization
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Email Address
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Contact Number
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Area Code
Phone Number
Street Address of Presentation
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Type of Organization
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Civic Group
Religious Organization
Elementary School
University
Business
Boy Scouts or Girl Scouts
Other
Requested Date or Date Options
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Requested Time or Time Options
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Average Audience Age
*
Average Audience Size (minimum of 25 people required)
*
Requested Length of Presentation (minimum of 45 minutes required, which includes Q&A)
*
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Are a projector and screen (for PowerPoints) available?
*
Is funding available for a mileage and per diem fee? (This only applies to requests outside of the greater Indianapolis area.)
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Please verify that you are human
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