CERC Training/Event Request Form
Contact Information
First Name
Last Name
Mailing Street
Mailing City
Mailing State/Province
Mailing Zip/Postal Code
Email
Business Phone
Organization
Employer/Organization Name
Event Information
Sponsoring Entity/Organization
Date of Event
What type of engagement are you requesting from CASL?
Speaking at an Event
Facilitating a Workshop/Training
Tabling at an Event
Event Topic
Target Audience
Expected attendance
Specific CASL Staff Requested (optional)
Event Summary and Details