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/
dhh 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

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