Name:

Phone Number:

E-mail:


Name of event and date


Location (facility, address, city)

Directions (from downtown Tampa) & parking


Number of people attending (If this is a class, what grade?)

Are you seeking a speaker or an emcee? If speaker, most all our on-air people plan on about 20 min. Is that appropriate for this event and audience?

Please include any description of the event that will help our speaker/emcee understand the purpose and audience. If this is a class, in what way is this speaker helping to further recent classroom studies or lessons?