Requested Presentation Child Passenger Safety Basics Safe Sleep for Babies, 0-12 Months Requested day and date of presentation Preferred time of presentation Alternative day and date of presentation Alternative time of presentation Requesting organization Name of event location Address Address Address 2 City/Town State/Province - None - Alabama Alaska American Samoa Arizona Arkansas Armed Forces (Canada, Europe, Africa, or Middle East Armed Forces Americas Armed Forces Pacific California Colorado Connecticut Delaware District of Columbia Federate States of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming ZIP/Postal Code Event planning contact person Contact phone number E-mail address Contact person for day of presentation Contact phone number for day of presentation Number of expected attendees Maximum number of attendees Age range of children in the families attending Your organization must meet the following criteria: - Presentations should be requested at least four to six weeks in advance. - Registration for the presentation is required. Organization must provide names, addresses, and emails of those in attendance. - Minimum enrollment is 6. - This presentation is intended for parents only. - Presentations are 90 minutes long, which includes time for questions and answers. - This will be a PowerPoint presentation. - In the event the presentation is canceled, it is your responsibility to notify the registered participants. - Material packets will be sent in advance along with PDFs and PowerPoint. - An evaluation link will be provided to participants, and the results will be shared with organizer. - Organization must provide meeting link unless it is otherwise agreed to use a BJC Teams meeting link. - Please note, presentations cannot be recorded. I understand that it is the responsibility of my organization to meet the above requirements I understand submitting this request does not guarantee the scheduling of this presentation
