Interested in having CERA present at your meeting?

Your Full Name (required)

Your Email Address (required)

Organization Name (required)

Organization Website (required)

Your Title/organizational connection?

Do you have specific presentation date(s) in mind?

Which topic are you interested in learning more about? (check all that apply)

Any topics of interest not listed here?

What is the community meeting format?

In Person

Online Web Meeting

Both In Person and Online Web Meeting

What is the address of your community meeting place?

Does the meeting facility have a presentation screen?

Yes

No

Not Sure

What audio and visual support equipment does CERA need to bring? (check all that apply)

Please attach any files that would be helpful to understand your needs