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Louisiana Department of Health & Hospitals | Kathy Kliebert, Secretary

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Statewide Initiatives



211 - Get Connected. Get Answers.

Secretary Speaking Request

Organization:
Event Name:
Preferred Date and Time:
Location:
Contact Name:

(First Name)

(Last Name)
Contact email address:
Contact phone number:
Contact person day of engagement:
Contact phone for day of engagement:
Suggested length of speech (include anyh Q&A):
Specific topics suggested for discussion:
Name, Title of person introducing the Secretary:
Approximate size of audience:
Audience Demographic (seniors, military wives, etc.):
Honoree names:
Honoree spouse or parent name:
Name, title of attending elected officials:
Are the media invited?:
Yes
No
Will there be a podium and microphone?:
Yes
No
Please provide parking and arrival instructions.:
Who will greet the Secretary on arrival?:
Do you have PowerPoint Presentation Capabilities?:
Yes
No
Please include any specific information about your organization that you think will be helpful for the Secretary (background of group, purpose for event, full agenda, etc.),
Helpful organization information:
Additional organizations involved with the event: