Special Investigations Unit (SIU) speaker-request form

Thank you for your interest in inviting our director or another SIU representative to speak to your group.

Please complete and submit this form at least four weeks before your event. We will review and repsond to your request as quickly as possible. Questions? Email us or call 360-725-7060.


* Indicates required field

Step 1. Your contact information
* Organization name
* Your name and title
* Daytime phone (xxx-xxx-xxxx)
* Contact email
(A copy of this request will be sent to this email address.)

* Would your organization consider an alternate speaker from our office, if the director is unavailable? Yes No

Step 2. Event details
Event title/name
Subject/theme of event
Estimated attendance
Date of event (mm/dd/yyyy)
Time of event (hh:mm a.m./p.m.)

Location of event (include address and room or other site information):

What would you like the director to speak about?

Step 3. Speech details
Start time of speech (hh:mm a.m./p.m.)
Time allotted for speech
Time for audience Q&A

Step 4. Other information

Is there any additional information we should know about your event?
 

Updated 03/21/2013

See also

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