If you would like to have an ALC Representative attend your event please complete this form. Submission instructions can be found on the bottom of the form.

1. [Continue to Next Page]
CONTACT INFORMATION
Your Name: Date:
Organization Name (if applicable):
Phone Number: Email Address:
EVENT INFORMATION
Date of Event: Time of Event:
Desired Length of Presentation: Estimated Attendance:
Address of Event:
City: State: ZIP Code:
Topics to be Covered:
Purpose of Event: Sponsors/Hosts of Event:
Other Speakers/Presenters at Event (if applicable):
ANTICIPATED ATTENDEE DEMOGRAPHICS
In your estimation, how familiar are the expected attendees of this event with the Transfer of Public Lands and related topics?
(On a scale of 1-10, with 10 being extremely familiar)
In your estimation, currently how supportive of the Transfer of Public Lands are the expected attendees of this event?
(On a scale of 1-10 with 10 being extremely supportive)
What concerns/questions do you anticipate the attendees of this event will have in regards to the Transfer of Public Lands?
(If you need additional space feel free to attach a separate sheet or email additional concerns to
Shelby@AmericanLandsCouncil.org).
American Lands Council
Presentation RequestPlease note: This form only represents a request for an ALC representative to
attend your event. Do not publicize the attendance of an ALC representative
at your event until you receive written approval and confirmation from ALC.

2. TRAVEL INFORMATION
Airport Closest to Event:
Do you/your organization agree to cover all travel expenses of ALC presenter related to the event?
**If event is cancelled after travel expenses have already been accrued your organization will still be
responsible for covering those expenses with the exception of cancelation by American Lands Council.**
SIGNATURES
Signing below signifies that the information provided on this form is as accurate as possible. Once this
form has been received by the American Lands Council your event will be reviewed, should the event be
approved this form will be signed by a representative of American Lands Council and a copy will be
returned to you.
Signature of applicant:
Date:
Signature of American Lands Council Representative:
Date:
Fill out form completely and return to Shelby@AmericanLandsCouncil.org or
to 10808 S River Front Parkway, Suite #334 South Jordan, Utah 84095. If
you have questions please call Shelby at 801-252-6622.