Coastal Health District Speaker's Bureau - Georgia Coastal Health District Georgia Coastal Health District

Coastal Health District Speaker’s Bureau

Welcome to the Coastal Health District Speakers Bureau – the most convenient way to request a speaker or other special appearance by a local public health subject matter expert.

Please complete the form below and we’ll get back to you as soon as possible. All requests are handled on a first-come, first-served basis and not all requests can be accommodated due to general obligations and availability.

If you are a human and are seeing this field, please leave it blank.

Fields marked with a * are required

About You

Your name: *

Work phone number: *

In the field below, please leave a phone number we can use to reach you in the evening or on weekends, particularly if we need to get in touch on the day of the event.

Evening/Weekend mobile phone number: *

Email address: *

About Your Organization

Your organization's name: *

Tell us a little about your organization:

How many members belong to your organization?

About Your Request

Event title: *

Event location/venue name:

Venue street address: *

City: *

Zip / Post Code: *

Event date & time: *

How many people are expected in the audience? *

Describe the audience: *

Examples: "physicians," "counselors," "mostly parents," "high school students," etc.

Desired length of speech or address: *

Your expectation of speech or address: *

Generally describe the nature of the speech and what the audience may want to hear.

Are PowerPoint and projection equipment available? *

Yes, they are available.
No, they are not available.

Use this space to add any additional notes on arrival, accommodations, special requests, etc.

Georgia Coastal Health District