Community Presentation Request Form

Please provide the information below and submit at least three weeks prior to the event date. Submitting this form does not guarantee participation by the American Red Cross. A chapter representative will contact you when the form is received.

For additional information, please contact us:

Greater Kansas City Chapter of the American Red Cross
211 W. Armour Blvd
Kansas City, MO 64111

Phone: 816-931-8400
E-mail: info@kcredcross.org

*Please fill out all required fields.**
Name of Event/Topic of Presentation*:
Date of Event*:
Sponsoring Organization(s):
Location of Event(s)*:
Directions to Site*:
Expected Attendance*:
Time of presentation*:
Duration of presentation*:
Audience*:	Adults
	Children
	Families

Describe the goal of the event and what role the American Red Cross plays in helping reach this goal*:

Specifically, how would you like the American Red Cross to participate*: (please check all that apply)
	Presentation
	Display
	Other
Will your organization provide any of the following accommodations*: (please check all that apply)
	Table/Chairs	Electricity
	Overhead projector/Screen	TV/VCR
	LCD projector (Powerpoint)
Is there any other information you would like to provide that you think might be helpful?


Contact Person*:
Phone*:	Ext.:
Fax:
E-mail*:
Additional contact information (address, email, website, etc.):

American Red Cross Greater Kansas City Chapter 211 W. Armour Blvd. Kansas City, MO 64111 USA		Phone 816-931-8400 Fax 816-531-7306
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