Please complete and submit this form for more information about booking a Speakers Bureau program for your next business, civic or community group meeting.

*Indicates required fields
Group/Organization Name
*Last Name
*First Name
*Street Address
*City
*State    *Zip Code
  
*Phone Number - enter at least one number where you can be contacted between 8am and 4pm, Monday through Friday. Format: xxx-xxx-xxxx.
Home Phone   Work Phone   Cell Phone
*Email Address

*I am interested in: (select one or more programs)
America's National Parks
And He Lived to Tell: The Incredible Story of Louie Zamperini
A Sense of the World
Book Bites
Data Mining @ the Library
Destiny of the Republic
eBooks Made Easy
First Mothers
Flags of our Fathers
Heroes and Characters of the Miami Valley
Introduction to eBay™
Introduction to Genealogy
Intro to Online Social Networking
Norman Rockwell's America
Online Job Searching Strategies
Our Favorite Humorist: Erma Bombeck
The Book of Kells
The Esther Price Story
The Life of Mary Todd Lincoln: Hellcat or Helpmate?
The Story of the U.S.S. Indianapolis
Other
*Date Requested (Format: ##/##/##)
*Start Time
  (Format: ##:##/Hour:Minute)
*End Time
  (Format: ##:##/Hour:Minute)
*Location