Knowledge Exchange Presentation Request

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Please complete this form to request a Knowledge Exchange Presentation.

Non-Profit or Public Service Organization Name

Point of Contact Name

Email

Point of Contact Phone Number

Additional Request Information:

Location of Organization

Detroit, MI Metro Area

Grand Rapids, MI

Lansing, MI

Michigan Indigenous Organization

Other Michigan Location

Columbus, OH Metro Area

Toledo, OH

Ohio Indigenous Organization

Other Ohio Location

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Qualification Criteria Confirmation:

Opt-In

By checking, I affirm I am submitting this request on behalf of a non-profit or public service organizaiton.

Opt-In

By checking, I affirm the organization I represent would be willing to hold a meeting with Dr. Ioerger to provide an overview of the organization and its services, in exchange for giving a presentation from his existing catolog. (The CGM workshop is not eligible for this offer.)

Knowledge Exchange Request