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West Basin Municipal Water District - Speaking Opportunity Request Form
Contact: Darryl Ramos-Young,
DarrylR@westbasin.org
, (310) 660-6216
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* Indicates required question
Email
*
Your email
1. Organization Name:
*
Your answer
2. Contact name:
*
Your answer
3. Contact email:
*
Your answer
4. Contact phone:
*
Your answer
5. What topic(s) would you like West Basin to speak to?
*
Who is West Basin Municipal Water District?
West Basin Recycled Water Projects
Drought Update
West Basin Water Conservation Programs
Doing Business with West Basin
Other:
Required
6. Requested date of event
*
MM
/
DD
/
YYYY
7. Requested time of event
*
Time
:
AM
PM
8. In case the provided date and time does not work, please provide 1-2 alternative dates and times for West Basin to consider.
*
Your answer
9. Size of group:
*
Your answer
10. Meeting location and address:
*
Your answer
11. Please describe any parking information our West Basin speaker may need:
Your answer
12. Arrival time of speaker:
*
Time
:
AM
PM
13. Presentation length:
*
Your answer
14. Would you prefer a specific West Basin speaker? If so, please list their name below.
Your answer
15. West Basin must bring:
*
Laptop
Projector
Screen
USB flash drive
Handouts
Required
16. Will the presentation be needed in advanced?
*
Yes
No
17. If you answered yes to the question above, when will you need the presentation?
Your answer
18. Has your organization had a West Basin talk before?
*
Yes
No
19. If you answered yes to the question above, when did West Basin give your last talk?
Your answer
20. Please list any additional information about the event you would like to mention:
Your answer
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