Outreach/Training Request Form

Thank you for contacting the Office for Historically Underutilized Businesses for your outreach request.

Please complete the form below to help us understand your outreach needs at least 30 days in advance of your preferred event date.

All approved requests are determined based on budget and staff availability.

Requesting Organization: *

Address *

City: *

State: *

Zipcode: *

First Name: *

Last Name: *

Phone Number: *

format 000-000-0000

Email Address: *

Will this Outreach/Training be held at the above location? *

Yes

No

Request for HUB: *

Date and time of presentation/exhibit (Please provide TWO DATE OPTIONS ):

1st Option:

1st Date: *

Month

Day

Year

Time: *

Hour

:

Minute

2nd Option:

2nd Date: *

Month

Day

Year

Time: *

Hour

:

Minute

Length of presentation/exhibit? Hour(s) *

Approximate number of attendees? *

Please describe exactly what you would like the HUB Office to do: *

Math question * 1 + 15 =

Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.

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