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2. 

4. Complete this form to request a subject matter expert from Beaufort-Jasper Water & Sewer Authority speak at your event.

6. Organization & Name of Event*
8. Topics You Want Us to Cover*
9. How Many Attendees are Expected?*
10. Ages of Attendees, if under 21*
12. Event Date & Start Time*
    Event Date & Start Time

    Event Date & Start Time
13. Duration, incl. Q&A*
14. Is this event recurring?*
    -- Select One --YesNo
16. Who is Speaking Before & After? On what subject?*
18. Event Address*
20. City*
21. State*
22. Zip Code*
24. Is this event in a gated community?*
    -- Select One --YesNo
25. If so, how will our staff gain access?
27. Point of Contact Name*
28. Point of Contact Phone Number*
30. Point of Contact Email Address*
32. Secondary Point of Contact Name
33. Email Address
35. Phone Number
37. What visual aids would be helpful for your group to see?*
39. Audio/visual equipment available*

    1. Computer
    2. Projector

    1. Monitor for audience viewing
    2. Screen
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41. 1. Receive an email copy of this form.
42. Email address

    This field is not part of the form submission.

43. Submit

* indicates a required field