Earth Day at Clermont College

Please supply the following information so that we can prepare for your participation and insure that you have all the supplies you need.

Presenter/Organization:
Contact Person:
Topic:
E-Mail Address:
Phone:
FAX:
Address:
Street:
City, State, and Zip Code:
Proposal (brief description of activities/displays):
Number requested
Tables (8 ft):
Chairs:
Other:
Note: The number of available electrical outlets is limited. Alternative energy sources are strongly encouraged.
Will you bring handouts or other information?	yes \| no