Presentation Request – STS North Carolina

Your Full Name *

Name of Organization *

Organization Website *

Your Email Address *

Address *

Street Address Line 2

City *

Zip Code *

Select State

Your Phone Number *

What STS North Carolina service would you like us to give a presentation? (select all that apply)Speech-to-Speech (STS)Video-Assisted Speech-to-Speech (VA-STS)‎Hearing Carry-Over (HCO)‎Other:

Preferred Date of Presentation *

Alternate Date of Presentation

How Long Presentation?

Number of Attendees? (approximate number)*

Comment

Request for Presentation
by STS NC

STS NC Outreach Consultants
give customized presentations
at no charge.