Classroom Speaker Request

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* 1. School and Address of School

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* 2. Grade(s)/Age range of students

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* 3. Number of Speakers Requested

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* 4. Estimated number of students

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* 5. Topic or Event

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* 6. Specific Date and Time of Event

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* 7. Technology Available for volunteers to use

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* 8. Name of Point of Contact at School

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* 9. Email Address and phone number of Point of Contact

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* 10. Will your speaker be in person or virtual?

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* 11. Additional Information