Office of the Ohio Consumers' Counsel

Speakers' Bureau Request Form

If you would like to request an OCC speaker for your organization's event or meeting, please fill out the form below. Alternately, if you don't have an e-mail account, you can send your request in any of the following ways:

Telephone the OCC at 1-877-742-5622 (toll-free in Ohio) or 614-728-6490
Fax your request to (614) 466-9475
Mail your request to OCC at 10 West Broad Street, Suite 1800, Columbus, Ohio 43215-3485

If you wish to mail or FAX your request, please fill out and send in our Speaker's Bureau Request Form.

Please fill this in as completely as possible; if you do not include a valid contact e-mail address and telephone number, the OCC will not be able to process your request for a speaker.

Contact Name:
E-mail:
Organization:
Street Address:
City:
County:
State:
Zip Code:
Telephone Number: (inc. area code)
FAX number:
Presentation Date:
Presentation Time:
Length of Speech:
Est. Number of Attendees:
Can we publicize the event?	Yes NO
Is this event open to the public?	Yes NO
Desired Speech Topic:

Presentation Location and Address:
Presentation City:
Zip Code:
Presentation Site Phone Number: (inc. area code)
Directions to Presentation and/or Other Requests:
Do you have the following equipment available?	Projection Screen Overhead Projector VCR Microphone
The information we receive from the following questions assists us with our target audience awareness, which helps us to better meet the needs of Ohio's residential utility consumers.
Are you between the ages of:	18 or under 19-29 30-45 46-64 Over 65
How did you first hear about the Ohio Consumers' Counsel?
It is important for you to have access to the Ohio Consumers' Counsel, your residential utility advocate, whose only job is to protect consumers and provide information about utility issues.	Very important Important Not important Not at all important Don't know / no opinion

Information believed accurate but not guaranteed.
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The Office of the Ohio Consumers' Counsel is an equal opportunity employer and provider of services.