Illinois Department of Public Health

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Request a Speaker

Do you need a speaker to talk about the SHIP and SHIP Implementation in your organization? Fill out the form below, and someone will get back to you within five business days. We will attempt to connect you with an appropriate speaker, but we cannot guarantee availability.

Name:

Organization Name:

Organization Website:

Your Phone Number:

Your E-mail:

Please describe your interest in SHIP:

Do you have a specific event and date in mind?
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Event Name:

Event Date:

Please let us know if you have any other special requests: