Availability Request Form

[ Download pdf version ]

Name of Event:

Sponsoring Organization:

Contact Person:

Email:

Work phone/tty:

FAX number:

Cell/alternate number:

Title of presentation requested
(or topic you would like addressed):

Date of presentation (if known):

Audience make up
(i.e. parents/professionals/
deaf & h/h adults etc):

Approximate numbers of participants:

Budget:

Copyright: Hands & Voices retains all ownership rights to presentation material. Presentation material may not be photocopied, distributed, customized, , displayed, or transmitted, in any form or by any means, electronic or mechanical, or any other use by Client or its associates, without the express written consent of Hands & Voices