CNIB Outreach Presentation Request

Thank you for your interest in hosting a CNIB presentation and helping to amplify the voices of people who are blind or partially sighted in your community. Please complete this webform with the required information and one of our staff members will contact you to facilitate and coordinate your request soon.

Details of the Contact at the Organization

Name of group, school, business or organization:

First Name:

Last Name:

Phone:

Email:

Region of Contact:

Details of Presentation

Date of the event (MM-DD-YYYY) - if known:

Time of the Event - if known:

Desired length of presentation (expressed in minutes):

Method of Delivery:

In-Person Event Details

Address of Location (Include Postal Code):

City:

Province:

Type of audience (e.g., staff, general public, etc.,.):

Size of audience:

Will there be other presenters?

If other, please write down the topic:

How did you hear about our outreach presentations?

Contact Information