South Coast Air Quality Management District
21865 Copley Drive, Diamond Bar, CA 91765-4182 (909) 396-2000 www.aqmd.gov
VISITING DIGNITARIES AND SPEAKER REQUEST FORM
If you would like the South Coast Air Quality Management District (South Coast
AQMD) to provide a speaker for an upcoming event or you would like to book a
tour for yourself or an organization, please complete this form. The request must
be made at least four weeks prior to your event.
Please return completed form via:
Fax (909) 396-3872
E-mail to speakersvisitors@aqmd.gov
Or mail your request to:
South Coast Air Quality Management District
Legislative & Public Affairs
Attn: Speaker Bureau and Visiting Dignitaries
Coordinator 21865 Copley Drive
Diamond Bar, CA 91765
Ph: (909) 396-2432
COMPANY/ORGANIZATION:
CONTACT PERSON:
PHONE NUMBER & E-MAIL:
DATE/TIME OF EVENT:
SOUTH COAST AQMD TOUR OR SPEAKER
NUMBER IN ATTENDANCE:
TYPE OF AUDIENCE:
MISC. INFORMATION
For Speaker Request:
SUGGESTED TOPIC:
LENGTH OF PRESENTATION:
EVENT ADDRESS:
Thank you for your interest. South Coast AQMD will make every attempt to fill your
Speaker or Tour request. Please note: tours may be canceled due to resource
constraints. If you have any questions, please call the Speaker Bureau/Visiting
Dignitaries Coordinator at (909) 396-2432.
