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Request for Presentation
A CapTel NC presentation can be provided at no charge to school, community or organization to educate individuals or groups about our captioned telephone services for people with hearing loss.
You can fill out the form below.
Name
*
Name of Organization or Event
*
Organization or Event Website
*
(example: http://www.yourwebsite.com)
Address
*
Address Line 2
*
City
*
Zip Code
*
Email
*
Phone
*
Please select type of Phone - select multiple options
Type of Phone
Voice
Videophone
CapTel
TTY
Other:
Best way to reach you
*
Email
Phone
Preferred Date of Presentation
*
Alternate Date of Presentation
Number of Attendees? (approximate number)
*
How long do you want the presentation?
-None-
30 minutes
45 minutes
1 hour
1 hour & 15 minutes
1 hour & 30 minutes
1 hour & 45 minutes
2 hours
Please select Any visual aid equipment - select multiple options
Any visual aid equipment available?
Large Screen
Projector
Internet
WiFi
Access to Electricity
Other:
Need flyers to promote the presentation?
Yes
No
Comment
Verification
*