Presentation Request Form

Avista would be happy to come to your school for a live presentation about how to be safe around natural gas or around electricity. You can request a presentation by completing the requested information below. Submit the form and we’ll notify you of the scheduled date. A minimum of two weeks notice is required and please note that your requested date is subject to availability.

Please select the type of presentation you would like to request:



Contact Information

*Contact's First Name:
Required.
*Contact's Last Name:
Required.
*Phone Number:
Required.
*School/Organization
Name:
Required.
*School/Organization Address:
Required.
*City:
Required.
*State:
Required.
*Zip Code:
Required.
*Contact's Email Address:
Required.
*Please provide a person and location for check-in prior to set-up: Required.

Presentation Date

Please indicate the date you would like us to make the presentation(s). Please include alternates. (Dates are subject to availability.)

*Date Requested:
Required.
*Alternate Date Requested #1:
Required.
Alternate Date Requested #2:
*Time:
Required.

Number of Participants

*Number of Attendees:
Required.
*Number of Classes:
Required.
*Grade Level(s):
Required.
*Average Age:
Required.

Comments

You may also include any additional comments you would like to make.

 


Internal Use Only

ID

BRC Code