Solid Waste Speaker Request Form

Solid Waste Speaker Request Form
PRESENTATION REQUEST: TERMS AND CONDITIONS

This form provides the terms applicable to request speaker engagements from Wake County Solid Waste Management Division staff. Our speaker engagements are:
- Intended for groups that operate within Wake County, NC
- Available Monday through Friday, from 9 a.m. to 4 p.m.
- Topic to be chosen from the list available (descriptions online)
- Require a minimum of ten (10) attendees
- Require an adult facilitator be present for participants under the age of 16 years
- Require two weeks advance notice
- Require the permission of the Wake County presenter to be recorded.
If your request for a presentation falls within the above terms, please complete the following request form. Complete one form per presentation.
Group/Organization Name:*
Contact Person:*

First NameLast Name
Phone Number:*
Please enter a valid phone number.
Email Address:*
example@example.com
Group/Organization Address:*

Street Address

Street Address Line 2

City/TownState / Province

ZIP Code
Group Size:*

10–1415–2425–3435+
Age Range (check all boxes that apply)*

11–16 years17–18 years19–65 years65 years+
Presentation Topic*

Waste ReductionRecycling DemystifiedBackyard CompostingThey Don't Build Landfills Like They Used To
Format*

In-personVirtual
Virtual Host:*

Wake CountyGroup Requesting Presentation
Online Platform:*

ZoomGoogle MeetMS TeamsWebExOther
Preferred Month(s)*

JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember
Preferred Day(s)*

MondayTuesdayWednesdayThursdayFriday
Preferred Time(s)*

9 a.m.9:30 a.m.10 a.m.10:30 a.m.11 a.m.11:30 a.m.Noon12:30 p.m.1 p.m.1:30 p.m.2 p.m.2:30 p.m.3 p.m.3:30 p.m.4 p.m.
Comments (include specific dates, learning needs, differentiated instruction, etc.)
Please verify that you are human*
Should be Empty: