Fatal Accident Investigation Unit Presentation Request Form

Primary theme of presentation *

Type of School: *

Presentation Type: *

The BCPO FAIU does not organize or coordinate Outdoor Reenactments. This option exists for schools and/or agencies who conduct their own reenactment and are requesting the BCPO FAIU to participate in same.

School Name (Primary) *

Town(s) of your School Services: *

Address of Presentation *

Address Line 1

Address Line 2

City

State

Zip Code

Approximate Attendance *

Approximate Time Allotted for Presentation *

Your Name *

First

Last

Your Title / Position *

Phone *

Email *

Email

Confirm Email

Messages and Comments

Date / Time of Presentation *

Date

Time

As the requesting organization, I hereby submit this form indicating our interest in hosting a presentation. I acknowledge that this information will then be distributed to the Speakers Bureau of the Fatal Accident Investigation Unit. If the Fatal Accident Investigation Unit can accommodate my request, I will be notified at the contact information provided. A mutually agreeable date and time will then be confirmed. *

I agree to the above terms.

Upon completion of this form, press submit, which verifies your understanding, agreement, and compliance with all guidelines established herein.

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