Event Presentation Request Form Availability: Online If you are having an event and would like Keep Henrico Beautiful’s Executive Director to attend, please fill out the request form and submit to us. Name First Last Email PhoneOrganization/ School NameAddress of Presentation Street Address City ZIP Code EVENT INFORMATION (Select One) SCHOOL GROUP (YOUTH) GROUP (ADULT) School Selection Classroom Assembly Age of ChildrenNumber of ChildrenNumber of AdultsClassroom: Grade LevelClassroom: Number of ClassroomsClassroom: Number of Students per ClassroomAssembly: Grade LevelsAssembly: Number of StudentsDesired Length of Presentation:Date: 1st Choice Month Day Year Date: 2nd Choice Month Day Year Date: 3rd Choice Month Day Year Equpiment Available DVD Player Any Additional Information or Questions