Schedule a Presentation

Your Name:

Enter your first and last name

Date:

mm/dd/yy

Enter today's date.

e-mail:

Enter a valid e-mail address

Phone Number:

Enter a phone number where we can reach you.

Mailing Address:

Enter your mailing address.

How many presentations?:

Enter the desired number of presentations.

Date of Presentation:

mm/dd/yy

Enter the desired date of the presentation. If more than one, list in the comments field of the form.

School Name:

Enter the name of the school.

Classroom or Assembly?:

Classroom

Assembly

Select either classroom or assembly for the presentation.

Comments:

Use if you need more than one presentation date or wish to include additional information.

OHSU — Oregon Health & Science University