Presentation Request

Date:

Scheduling Form Classroom Presentations - Electric Power and You, Natural Gas Safety, Water Conservation, Raptor Presentation Please submit a separate form for each presentation request. Colorado Springs Utilities does everything possible to fulfill every presentation request. Please consider your request confirmed unless you hear otherwise. You will receive an email approximately three weeks before your presentation confirming your scheduled date and time. Please note fields with asterisk () are required to submit this request

*Organization Name:
* Address of Presentation:
*Contact Name:
*Contact Phone Number:
*Contact E-mail Address:
*Which program are you requesting? (Choose only one): Electric Safety and You Natural Gas Safety Water Conservation Raptor Protection
*Requested date of presentation: (please use the calendar to choose date)
*If above date is not available, second choice: (please use the calendar to choose date)
*First Presentation Time:	a.m. p.m.
*Number of People:
*Age/grade of people attending:
Second Presentation Time: Use only if you are requesting a second presentation of the same program on the same day a.m. p.m.
Number of People:
Age/grade of people attending:
*Do you or any attendees have any special needs or requests? Yes No If yes, please list:

Scheduling Form