SPEAKER REQUEST FORM
Person Responding (& Title):______________________________________
School Name:______________________________________________________
Phone:________________________ Fax #:________________________
Address:__________________________________________________________
_____________________________________________________________
Principal's Name:_________________________________________________
Teachers Name:____________________________Phone:__________________
(If different from respondent)
Best times to reach you:__________________________________________
Grade(s):______________________ Group Size:______________________
Class Subject:____________________________________________________
PREFERRED LEGAL TOPICS:
_____ Domestic Violence Education
_____ Family Law Issues
_____ Juvenile Justice
_____ Motor Vehicle Laws
_____ Mediation
_____ Environmental Issues
_____ Financial & Workplace Issues
_____ Careers in Law
RECOURSE:
_____ Domestic Violence
_____ Parent-Teen Communication
_____ Diversity Awareness & Sensitivity
Preferred Times/Days:____________________________________________
_____________________________________________________________
Return to: Sonoma County Legal Services Foundation
1212 - 4th St. #I Santa Rosa, CA 95404 546-2924 or FAX
546-0263