Zero Waste outreach request form

1. First name: *This question is required.

2. Last name: *This question is required.

3. Organization or group name: *This question is required.

4. Phone number: *This question is required.

5. Email address: *This question is required. This question requires a valid email address.

6. Street address: *This question is required.

7. Unit number:

8. City: *This question is required.

9. Which opportunities are you interested in? *This question is required.You may select more than 1

Recycle Right seminar
Outreach booth
Lobby talk

10. Name of the event:

10. Name of multi-unit residential building:

10. Audience demographics: *This question is required. For example: students, families, program participants, age range, or any additional details.

11. Audience size: *This question is required.

12. Date requested: *This question is required. This question requires a valid date format of MM/DD/YYYY.

calendar

13. Preferred time: *This question is required.

14. Provide alternative date and time options if your preferred date is unavailable:

15. Provide a list of the type of equipment you can provide: For example: Projector, tables, chairs, microphone, speakers, tent, and any necessary items.

16. What do you hope your audience will learn? How will this create impact or behaviour change? *This question is required.

17. Additional comments or questions: