For Presenters

Please complete a copy of this form for each Operation Lifesaver presentation.

Name of Presenter *E-mail Address City State Zip Phone Date of Presentation Name of Group Receiving Presentation City/Parish Type of Audience(s) Receiving Presentation: Grade K-8 High School/New Drivers Industry General Info Drivers Ed Professional Drivers School Bus Drivers Adult Community Group Law Enforcement Traffic Judges Other Group Size of Audience No. of Presentations Given on Date Handout Material Used Video Used Contact Name Date Enter any questions or comments you may have: