Request a Speaker Contact InformationRequests for speakers must be made at least three weeks in advance of the desired visit date and are subject to availability.Name:* First Last Organization:*Primary Phone:*Email* Mailing Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Event InformationEvent Name:*Organization Hosting Event:*Organization Website:Type of Organization:*Community organizationEnvironmentally focused organizationWater related industryBusinessSchoolEvent Sponsor:Date*If multiple dates or flexible dates, please enter one date here and provide additional information at the bottom of the form. Event Start Time:* : HH MM AM PM Speaker Start Time* : HH MM AM PM Total Time Allotted for Speaker:*Event Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Presentation Type:*DemonstrationKeynotePanelOtherQ&A IncludedYesNoTopic Requested:*Speaker Requested (If known):Expected Audience Size*Indicate Available Equipment*Check all that apply LCD projector Computer with presentation software Computer with speakers Room can be darkened Internet access None available Are There Funds to Cover Travel Expenses if Necessary?*YesNoIs an Honorarium Available?**Honorariums support the education and research mission of the School of Freshwater Sciences and will be placed in the Friends of Water account at the UWM Foundation. Honorariums are not required. YesNoIf yes, what is the amount of the honorarium?Please provide any other information that may help clarify your request: