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Request an Emergency Preparedness or Hazard Focused Presentation
Sign in to Save Progress
This form has been modified since it was saved. Please review all fields before submitting.
If you would like a public educator from Pierce County Department of Emergency Management to speak about the hazards we have in Pierce County, how to create an emergency plan, and how to build an emergency kit, please fill out the form below.
Name of Agency or Community Group
Address of Presentation
City
State
Zip
Preferred Date, Time and Duration of Presentation
Please allow 1-2 weeks for a public educator to contact you regarding your presentation request. A confirmation or a request for additional dates/times will be sent via email. The duration of an emergency preparedness presentation can range anywhere from 20 minutes to one hour. Please keep this in mind when you provide a presentation time. The time frame you list does not include set-up or take-down. The presenter will set-up 10-15 minutes before the start of the presentation and take-down shortly after the presentation concludes.
First Choice - Date/Time
First Choice - Date/Time
First Choice - Date/Time
Second Choice - Date/Time
Second Choice - Date/Time
Second Choice - Date/Time
Preferred Duration of Presentation
Point of Contact
Before the presentation
First Name
Last Name
Email
Phone Number
Point of Contact
Day of the presentation
Check if same as above.
First Name
Last Name
Email
Phone Number
Audience
Audience Demographics
Please list audience demographics (i.e. age, special needs, etc.).
Expected Number of People
Does not need to be exact, estimating a number range will ensure that the public educators bring enough handouts for each audience member.
Technology
If you are unable to provide any of the items listed below, we can provide them for you.
Is there a computer or laptop available?
-- Select One --
Yes
No
Not Sure
Is there a projector available?
-- Select One --
Yes
No
Not Sure
Is there a screen or white wall to project on?
-- Select One --
Yes
No
Not sure
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