DHS Presentation Request

Thank you for your interest in learning more about the Department of Human Services (DHS). We are glad to have a DHS representative come to speak at your event. To help us identify the most appropriate speaker, please complete and submit the form below.

Your request must be submitted at least 2 weeks prior to the event.

Please allow 3-5 business days for a reply.

Requests containing offensive or defamatory statements are subject to no response.

Event Organizer

Name of event (required)

Event description

Event sponsor(s)

Type of organization

Event Details

Date of event (required)

Location of event (required)

Street address (required)

State (required)

City (required)

Zip code (required)

Presentation/Speech Details

Select area of interest

Requested topic

500 character limit

Presentation format (required)

Will the speech be followed by a “Questions and Answer” period? (required)

Audience: How many attendees are you expecting?

Special Guests: Please list the names and titles of any elected officials or senior executives attending the event.

Media: Will media be invited?

Additional Information

Deadline for acceptance:

Disclaimer/Release Form

Please indicate whether or not the event sponsor will need the speaker to sign a disclaimer/release form.

Any additional information

500 character limit

Additional attachments

One file only.
2 MB limit.
Allowed types: gif, jpg, png, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xlsxlsx, xml.

Contact Person

Name (required)

Title

Street address (required)

City (required)

State (required)

Zip code (required)

Cell (required)

Work phone

Email (required)

DHS Presentation Request

Call Us

Message

Mail