Portland FBI Speaker/Presenter Request Form

Contact Information

Contact Person:  

Position/Title:  

Contact's E-Mail Address:  

Contact's Phone:  

Contact's Fax Number:

About the Organization

Organization/Group Name  

Audience Type  

Business Professionals
Civic Group
Elementary-Age Children
Faith-Based Organization
Law Enforcement
Seniors
Teens
Other (describe below in comments section)

Presentation Date/Location

Event Date/Time:  

Event Location:  

About the Event

Purpose of the Event:  

Number of Attendees Expected   (minimum 25 attendees)

Length of Presentation (e.g. 30-45 minutes)  

Presentation Topic

Choose a topic that suits your event (select all that apply)   *CREST Program Link FBI Overview Terrorism CREST Program* Cyber Crime Public Corruption Gangs Civil Rights Recruitment and Hiring Youth-Based Presentation Other (describe below in comments section)

Other Event Information

Will there be Q&A afterwards?  

Yes
No

Will there be audio/visual equipment available for PowerPoint slides?  

Yes
No

Is a bio needed for the speaker?  

Yes
No

Will media be present?  

Yes
No

Do you plan to do any publicity related to this event (either before or after), including through press releases, websites, blog posts, photos, or other means?  

Yes
No

If yes, please explain.