Douglas-Sarpy Extension Speaker Request Form

All requests are subject to availability. Staff will contact you with a confirmation call/e-mail. There may be a fee involved in certain programs for supplies.

Please note, due to the volume of requests, staff are limited to one horticulture program request per group, per year.  30 days notice required for speaker visits.

FIRST DATE CHOICE: *
SECOND DATE CHOICE: *
START TIME: *
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END TIME: *
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WHAT IS THE BEST WAY TO CONTACT YOU? *
SCREEN AVAILABILITY (FOR POWERPOINT): *