Speaker Request Form

Complete the following form and click Submit to request a speaker.

Contact Name*
First Last
Organization Name
Email*
Enter Email Confirm Email
Phone*
Preferred Method of Contact*
- Email
- Phone
Date of the event*
Date Format: MM slash DD slash YYYY

(BCMGA requests a three week notification to allow time to find appropriate volunteer speakers)
Time the event starts*

HH :

MM
Address of the event*
Street Address Address Line 2 City State ZIP Code
Presentation Topic*
Length of presentation*
Estimated number of attendees*
Please enter a number greater than or equal to 10.
Is your event open to the public?*
- Yes
- No
Equipment that will be available*
Honorarium?*
- Yes
- No
Date by which you need a response.*
Date Format: MM slash DD slash YYYY

(BCMGA requests a three week notification to allow time to find appropriate volunteer speakers)
Additional Comments

Bastrop County Master Gardener Association Mission Statement

BCMGA’s mission is to support our Extension Agent by using scientific-based knowledge to create high-quality, relevant continuing education that encourages lasting and effective change. The objectives are to provide programs, tools, and resources that teach people how to improve agriculture and food production, advance health practices, protect the environment, strengthen our communities, and enrich youth.