1

Please provide your contact information for follow-up on the request. *Please note, no request is confirmed until you receive confirmation and reach-out from a staff member*

 *

Please provide your contact information for follow-up on the request. *Please note, no request is confirmed until you receive confirmation and reach-out from a staff member*

Requester's Name

Organization (if applicable)

Phone Numberext.

Email

2

What service are you requesting?

What service are you requesting?

I would like to request a guided hike

I would like to request a speaker at an event

3

Please provide an estimate for how many will attend?

Attendee Count:

4

What is the date and time of the event you are requesting?

What is the date and time of the event you are requesting?

Please select the date for your requested event

Please select the start time of your requested event

I do not have a particular date or location in mind and would like to schedule the next available

5

What is the location of the requested event?

What is the location of the requested event?

Location of Speaking Event

Name of Conservation Collier Preserve for Guided Hike Location:

6

Guided Hike or Presentation Theme- Do you have a particular topic you would like addressed?

Topic if Applicable:

7

Is there a specific Conservation Collier staff member you are requesting to schedule with? If not, please indicate N/A.

Is there a specific Conservation Collier staff member you are requesting to schedule with? If not, please indicate N/A.

8

If requesting a public speaker at an outside event, will this be a PowerPoint presentation and what technological accommodations are provided (ie: laptop, projector, microphone, etc.)

If requesting a public speaker at an outside event, will this be a PowerPoint presentation and what technological accommodations are provided (ie: laptop, projector, microphone, etc.)

List of technology available at the speaking location:

This is not applicable to my request type

9

Is the requested service location within Collier County?

Is the requested service location within Collier County?

Yes

No

Once your request is submitted, a member of the Conservation Collier Program staff will be in touch to confirm and schedule your requested service within one week of submittal. Please note all requests are tentative until confirmed in follow-up by staff. The primary form of contact is via the email address you provide. If you have any follow-up questions, please reach out to Conservation Collier staff at 239-252-2961 or ConservationCollier@CollierCountyFL.gov. 

1. To receive a copy of your submission, please fill out your email address below and submit.
2. Email Address

Page 1 / 1