Request for Safety Demonstration

Hot Line Safety Presentation

Thank you for your interest in MVEC's free safetyTown demonstration. Please fill out the following information, and your presentation time will be confirmed as soon as possible. If you have any questions, please contact Susan at 952.492.8258 or susanl@mvec.net.

*Field is required. Use N/A for all fields not applicable or unknown.

Date of Event*
Time event begins*

: HH

MM

MVEC presenter will arrive approximately half an hour prior to this time to set up the presentation.
Time event ends

: HH

MM
Name of School or Group*
Contact Person*
First Last
Contact Person's Phone Number*
Alternate Phone Number
Email*
Location of Event
Street Address City State ZIP Code
Where should MVEC presenter report and/or set up?
This can include where to park, which door to enter, where to check in and any other special directions.
Age of Audience*
How many students/participants will be in attendance?*
How many half-hour sessions does your group require?
For the best viewing and participation opportunity, 25 students or fewer is ideal.
Additional information
This can include whether your event is part of a certain grade's curriculum, career day, open house or any other pertinent information that may help customize your event.
To ensure an actual person is filling out the form, please answer the following question: 1+6*
Please enter a value between 7 and 7.

Hot Line Safety Presentation

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