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Speaker Request Form



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