Energy City Speakers
Please contact the City's Environmental Administrator at 763.635.1068 if you are interested in having someone speak to your group or fill out the form below.

Speaker/Presentation Request Form

Date of Request:
First Name:
Last Name:
E-mail address:
Office Phone Number:
Cell Phone Number:
Affiliation:
Presentation Location:
Presentation Date:
Presentation Time:
Audience Size:
Audience Make-up (check all that may apply): Elementary/middle school age students
High school age students
Studying environmental issues
Government
Other (describe):
Preferred Response Method: Office phone
Cell phone
Email
Any additional comments:


When you are done...