Outreach Request Form

Community outreach and education is an important part of DIR’s mission in serving California’s workforce and businesses. To request that a member of our department attend your event or to request a meeting with a subject expert, please complete this online form.

Note: We respectfully request that you allow for 10 business days to reply to your request. We will subsequently contact the requesting party and the accommodation of events will be considered on a case-by-case basis depending on the level of requests received as well as the varying schedules of our staff and subject experts.

1. Name of Organization:

3. If you have already contacted a member of DIR to arrange for a speaker or participant for your event, please list the person’s name.

4. Are you a COVID-19 Workplace Outreach Project (CWOP) member or were referred by one of the following organizations? *This question is required.

5. Topic, goals and purpose of the presentation or event:

6. Title of presentation or event ?

7. Date of the presentation or event: This question requires a valid date format of MM/DD/YYYY.

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8. Time of the presentation or event:

9. Duration of the presentation or event:

10. Address for the location of the presentation or event:

11. Who is expected in the audience?

12. Anticipated number of attendees: This question requires a valid number format.

13. Is this event open to the public?

14. Is there a cost to attend?

15. How will you publicize this event?

Comments

16. Briefly describe the services of your organization:

17. Program Contact Person's Name and Title:

18. Address of Contact Person:

19. Telephone Number of Contact Person:

20. Email of Contact Person: This question requires a valid email address.

21. How would you like to be contacted?