Presentation Request Form
Please complete the form below with the required details. After submission, our team will review your request and contact you within 5 business days to confirm presenter availability and next steps. Thank you!
Which Presentation are you requesting?
*
NAMI Ending the Silence (ETS)
Mental Health & Stigma
Mental Health 101
Too Blessed to Stress
Stress Management pt. 2
NAMI Ending the Silence Families
NAMI In Our Own Voice (IOOV)
Mindful Me Series
What language would you like your presentation provided in? *Note: We offer presentations in English or Spanish. If you are requesting a bilingual presentation or another language, an interpreter will need to be provided.
What are your guidelines for timeframe for the presentation?
e.g. "20 minutes, 30 minutes, 1 hour"
Proposed Date
*
-
Month
-
Day
Year
Date
Proposed Time
*
Hour Minutes
AM
PM
AM/PM Option
Are you requesting more than one presentation at the same location?
*
Yes
No
Additional dates/times
*
Organization Name
*
Organization's website or brief description of organization's work
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Will the presentation be held at the organization address?
*
Please Select
Yes
No
If you answered "no" to the previous question, please add the presentation address.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Contact Person
*
First Name
Last Name
Phone (Primary)
*
Please enter a valid phone number.
Email
*
example@example.com
Are there any parking instructions or building information (room number for example) or other information that would help the presenters find the presentation location?
*
Is the presentation location ADA compliant?
*
Please Select
Yes
No
Intended Audience
*
Estimated size of audience
*
What A/V equipment do you have available?
*
DVD Player
TV (for DVD)
Computer (for PowerPoint or DVD)
Projector with Screen
Microphone
Other
Will this presentation to be open to the public? Note: Public presentations may be posted on our website, within newsletters, or other forms of promotion.
*
Please Select
Yes
No
Maybe, not sure yet.
Do you have additional comments or considerations for this presentation request?
Submit
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