Speaker Request Form – Dov Block – Master Gardeners of Greater New Orleans

Requested Topic: *

Date / Time of Presentation: *

Date

Time

Select Type of Presentation: *

If you are requesting an in-person presentation, will you have an HDMI-Compatible TV available to project the PowerPoint?

Time Allowed for Presentation (min. 30 min.) *

Location of Presentation: *

Address Line 1

Address Line 2

City

State

Zip Code

Expected Number of Attendees *

Organization: *

Contact Name: *

Contact Title: *

Contact Phone: *

Contact Email Address: *

Speaker Request Form – Dov Block