Anti-Idling Presentation Request * 1. Thank you for your interest in an anti-idling presentation. We'll do our best to match you with a presenter. In addition, you can become trained to become a presenter yourself. If interested, please click on the link to volunteer at www.motor-smart.org.Please give your name and the name of your organizaton. Name Organization * 2. Please give us the email address (preferred) or telephone number we should use to contact you. Email address (preferred) Telephone number * 3. Please give the name and address of the place where you would like the presentation. * 4. When would you like this presentation? I have a preferred date. (Please enter the date below.) Sometime within the next month. Sometime in the next three months. Please enter your preferred date. * 5. What is your preferred time? During the school day. A weekday evening. On a weekend. * 6. Who is the audience? Elementary school students. Middle school students. High school students. University students. School, parent, teacher group. Adults. Senior citizens. * 7. What is the approximate size of the audience? * 8. Is this presentation open to the public? Yes. No. * 9. We'd like to show a four-minute video as part of our presentation. We will bring the video on a DVD. Does your venue have necessary the AV equipment available to show it? Yes No * 10. Do you have any other needs or is there additional information we should know? Done