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Outreach Activity Request

1. Contact person for the activity:
Name*
Address*
Telephone No.*  (xxx-xxx-xxxx)
Email*
2. Purpose of the activity:*
Please indicate which customer choice you are interested in learning more about
Electric
Natural Gas
Telecommunications 
Other
3. When and where would you like to schedule the activity:
Date*
      
Time*    
Location*    
4. Subject to discuss:
For example: How to choose an electric generation and transmission supplier. Who are telephone local service providers and how do their rates compare?
5. Number of people expected to attend the activity:
6. Will the participants be:*
Residential
Commercial
Both
7. Is there any other information you would like to share with us to help us ensure the outreach activity satisfies your needs?
8. Will audio and/or video equipment be available for use with the presentation?
Yes     No
  
Item marked with an * is mandatory.
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