LubbockUW

Lubbock Area United Way Logo

Company/Organization

First Name

Last Name

Mobile Number

(Why do we ask? We need your mobile number so if there is a problem on the day of your event, the speaker or a staff member can get hold of you.)

Office Number

Event location

Event Date

Event start time:

# of people expected to attend:

Event Type

Loaned Executive (if applicable)

Venue Details

If other, please describe.

Who will we be sharing with? (check all that apply)

Office staff

Sales Team

Medical staff

Educators

Warehouse

Drivers

Other

If other, please describe

Please share anything else a speaker might need to know like where to park, what entrance to use, etc.

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