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Speaker and Event Request

New Jersey's Clean Energy Program

Event Staffing and/or Speaking Engagements
Request Form

In order for New Jersey's Clean Energy Program to review opportunities for event participation, the following information is necessary. The questions that require an answer are marked in red.

*Please note that the program only supports NJ-based events.

Name of Event
Contact Person
Email
Phone
Event Location
*Please note that the program only supports NJ-based events.
Venue Name
Street Address
Address cont.
City
State
ZIP Code
 
Event Dates / Times
Audience Type
*Please select all that apply
Residential
Commercial
Government
Type of Request Speaker
Tabling/Exhibit

If a speaking request, is it part of a panel discussion?
Commitment Deadline
Is this a reoccurring event?

If Yes:
How many years:

Previous audience attendence:


If No:
Anticipated audience number for this event:
Will you promote this event?

How?
If speaker is requested, what materials will be provided? (ie. stage, podium, table, microphone, etc.)
If applicable, please list elements included in sponsorship:
Cost of participation:
(Cannot include any cost for refreshments.)
$
Organizers entity type:
*Please include all that apply
Association
Business
Chamber of Commerce
Not-for-Profit
Private
Public
School
Trade Organization
Other/Additional Details:

*Although New Jersey's Clean Energy Program tries to accommodate all event requests, filling out this form does not guarantee participation in any specific event*.

You will be notified regarding our ability to support your event within ten business days.

Code:
*3ZaCW4B
Please enter the code shown above:

Find a Program



Program Literature

Applications and Brochures - Download Program Materials

Energy Master Plan

State of New Jersey Energy Master Plan

Follow Us: Become a Facebook Fan!Follow us on Twitter!


New Jersey State Seal