CEMA Outreach Presentation Request Form
1. To request a presentation from CEMA for your organization, please fill out the form below.
2. ATTENTION! If you need confirmation before three (3) business days, please complete this form and call the office at 912-201-4500.
3. If you need to cancel your request, please do so within 24 h of the requested date.
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Email *
Disclaimer
If you are requesting a presentation outside of regular business hours, after 5 PM or during the weekends, there must be at least 10 confirmed participants.
*
Required
Organization Name
Point of Contact: First Name and Last Name
 *
Will above point of contact be on site?
 *
If you selected no, please list who will be available. If you selected yes, please select not applicable
 *
Phone Number
Email Address
Event Address: street address, zip code, suite number etc.
 *
Is onsite parking available?
 *
Requested date of presentation.
Weekend and evening requests must have at least 10 confirmed participants.
 *
MM
/
DD
/
YYYY
Alternative date (if the primary requested date is not available) *
MM
/
DD
/
YYYY
Time of presentation request
Weekend and evening requests must have at least 10 confirmed participants.
 *
Time
:
Presentation Topics
 *
Required
Presentation Length
 *
Number of Attendees
Weekend and evening requests must have at least 10 confirmed attendees.
 *
Audience
 *
Required
What media/AV equipment will your venue provide?
 *
Required
Submit
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