Request a Speaker Form

Need a speaker from the Jefferson County Attorney's Office?  Please fill out the form below to give us more information.  Someone from our communications office will respond to your request as soon as possible.  Please note that we require a 3 week lead time to schedule a speaker. 

Our office fields requests to speak on a number of topics including:

  • Domestic Violence
  • DUI
  • Newly arrived immigrants
  • Child Support
*Required
Date
First Name *
Last Name *
Address *
City *
State *
Zip Code *
Contact Phone # ext: *
Email Address *
How many people do you expect at this event?
What time should the speaker arrive?
Is there a contact person the speaker should as for?
How much time is required for the speaker?
Please give us more information on the type of event below:
 

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