Telephone Request
For United Way Speakers
   
Company Requesting Tour ___________________________________
Company Contact Name _______________________________
Address ________________________________
Phone ______________   Fax _________________
E-mail Address __________________________


Tour Request #1
Agency (first choice) ____________________ (second choice) _______________
Time (first choice) ______________________ (second choice) _______________
Date (first choice) ______________________ (second choice) _________________
Group Size _________


Tour Request #2
Agency (first choice) ____________________ (second choice) _______________
Time (first choice) ______________________ (second choice) _______________
Date (first choice) ______________________ (second choice) _________________
Group Size _________

All tours should be requested at least two weeks in advance.
After completing the above information, call the United Way Office
at 937-383-4846 to place your request or fax form to 937-383-0956.
It may also be emailed to unitedwaycc@in-touch.net

We have the Power to Make a Difference!