Lee County Florida – Emergency Management Speaker Request Form
To help create a better prepared community, Lee County Emergency Management provides
information and speakers to discuss Emergency Preparedness and Hurricane Preparedness. To
request a presentation, complete this form and hit the “Submit by Email” button (preferred) or
print it and return by FAX to 239-477-3636.
NOTES:
Seminars are free of charge and are conducted year round during day and evening hours.
You are free to invite additional participants (i.e., Red Cross, fire department, law enforcement
or other experts of interest).
Our presentation can be adjusted to last for 20 - 60 minutes to better meet your schedule.
Except for special events, we typically do not schedule seminars on weekends or holidays.
Emergency Management does not endorse, or advertise, any specific product or service.
This is limited to Lee County. In other areas, contact you local emergency management agency
for similar programs.
Please tell us about yourself and your seminar location:
(For planning purposes only, to help ensure we bring adequate hand outs.)
When would you like to conduct your seminar?
If you have questions or need more information,
contact our office at 239-533-0622.
Name of the Speaking Location:
Address of the Location:
Your Name:
Your Email Address:
Your Telephone Number:
The Organization You Represent:
How many people do you expect to attend?
Preferred Date:
Time:
Alternate Date:
Time:
