MGCC Speaker Request Form

UC Master Gardener Program of Contra Costa County

Speaker Request Form

Use this form to request a speaker from the UC Master Gardener Program of Contra Costa County to deliver a presentation, workshop, lecture or speech at your location. Once we have this information, we will work to find a speaker for your event. Because of the time required to locate a speaker, and work on materials, we request a 2 months advance notice for speaker engagements.

Provide as much information as possible in order to be matched with the best speaker for your needs and to allow the Speaker’s Bureau Coordinator to provide the right type and quantity of materials.

A volunteer from our Speaker's Bureau will be in touch with you soon after receiving your request.

✻ = Required

Contact details

Hosting Organization Name ✻

Your Name ✻

Phone Number ✻

Email ✻

Organization background:

Please tell us about your organization (when established, mission, membership)

Event location

Event Name (for example: monthly meeting, teacher training session, etc.) ✻

Event Location Name ✻

Event Street Address ✻

Address line 2

City ✻

State

Zip code

Event Date(s)

When is your event? Please format mm/dd/yy ✻

What time will the event begin and end? (for example when your meeting starts and ends) ✻

How many times will the presentation be given? ✻

Once Once per hour Every half hour

Is it a multi-date event where the same presentation will be given? (Please see detailed questions below about multiple topics/dates)

Yes No

Is the event different than the address given above?

Yes No

Alternate address

Topic and Format

Which format will the presentation be?

✻

In Person On-line (i.e. Zoom)

What type of presentation will this be?

Formal Informal Hands On Demonstration

For hands on presentations, are you able to provide materials for participants to use?

Yes No

How long do you wish the presentation to be? ✻

Include additional time for Q&A? (at least 10 to 15 minutes) ✻

Yes No

When will be the presentation be given? (Please give exact times, eg. 1:15 - 2 pm, not including set up and tear down) ✻

Audience

What level experience do you expect your audience to have?

Promotion, Speakers and Media Contra Costa County Master Gardeners may promote public events within our online event calendar, website, public email newsletter or social media outreach.

Is this a public event? ✻

Yes No

Other logistics

Other event speakers? Press invited to event? Broadcast? Recorded and available for streaming?

How will you promote this event? Select all that apply ✻

Flyers Radio Television Website Social Media (see below) Email newsletter Other

Broadcast Live via Social Media?

No this program will not be broadcast Live on Social Media Yes on Facebook live Yes on YouTube LiveStream Yes other streaming service

Facebook Live link

YouTube Livestream link

Twitter @

Instagram @

Social media/Promotion contact name and email

Will you require a speaker biography?

Yes No

Will you require a speaker photo?

Yes No

Event capacity - how many people may attend?

Additional venue notes: quality of chairs, types of equipment, other details that are helpful to know.

Attendee Contacts

After each program, the UC Statewide Office sends out a voluntary survey to participants. Attendee contact information (name & email address) is needed to send out this survey. Can you share contact information of those who attended? ✻

Yes we can share contact info No but we can send the attendees the link to Master Gardener voluntary survey to collect contact info No but we can have a sign in sheet at the event to collect contact info