Request a Speaker for Your Event

2. Thank you for your interest in having a representative from Linn County's Sustainability Department speak at your event. To help us give your request full consideration, please provide us with as much detail as possible about your event and requested topic.

   Fields marked with an asterisk (*) are required.

4. First Name of Person Submitting Request*
5. Last Name of Person Submitting Request*
7. Name of Organization Submitting Request*
9. Organization Address1*
11. Organization Address2*
13. City*
14. State*
15. Zip*
17. Contact Person Email Address*
18. Contact Person Phone Number*
20. Organization Website Address
21. Speaking Date and Time Requested*
    Speaking Date and Time Requested

    Speaking Date and Time Requested
23. Event Title*
24. Event Topic*
26. Event Description/Purpose*
28. Speaking Topic Requested*
30. Organization Description*
32. How did you hear about the Linn County Sustainability Department?*
Leave This Blank:


34. 1. Receive an email copy of this form.
35. Email address

    This field is not part of the form submission.

36. Submit Submit and Print

* indicates a required field