Outreach Request Form

Outreach Request Form

Thank you for filling out this outreach request form for The Wild Center. After we receive your information we will try our best to accommodate your request. Not every request can be fulfilled due to staffing constraints or travel distances but we aim to participate as much as possible. We value our relationship with the community and thank you for asking us to be a part of your event. After reviewing your information and our staffing numbers we will reply to your request in a timely manner.

*Please note that The Wild Center is unable to bring live animals offsite. If you are interested in a live animal program, please let us know and we can arrange for something at The Wild Center.*
Organization*
Event Title*
Event Date*

MonthDayYear
Date
Location of Event*
Event Time*

Hour Minutes

AM/PM Option

Until
until
Hour Minutes

AM/PM Option
Contact Information
Name*

First NameLast Name
Email*
Phone Number*
Event Information
Does this event ask for an educational activity or component from The Wild Center?*

YesNoPotentially
Description of Event
Repeating Event
Time The Wild Center staff can arrive to set up

Hour Minutes

AM/PM Option
How many people are you anticipating being in attendance?
What are you requesting The Wild Center staff to do at the event? teach, lead a workshop, table/share info about TWC, etc.
Describe the space and the amount of space provided. Include supplies provided and what would be needed to bring.
Is there an honorarium, mileage coverage, included meals, or anything additional offered?
Is there a limit to how many Wild Center staff can be present?
Is there a commitment deadline? If so, when is it?
Is there anything else we should know or be aware of?
Upload any event flyers, images, or additional files that we have permission to use in event promotion.

Cancelof
Should be Empty:

Outreach Request Form

Contact Information

Event Information