Request a Speaker | Oklahoma Insurance Department

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INSURANCE COMMISSIONER

Glen Mulready

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Please complete the following information to request a speaker from the Oklahoma Insurance Department. Request subject to availability. All requests must be made at least sixty (60) days in advance. All speech requests subject to cancellations.

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Request A Speaker Form

Step 1 of 4

25%

Event Date*
MM slash DD slash YYYY
Event Time*
Number Attending*
Primary Audience*
Group or Organization*
CE Requested? (speech must be 50 minutes in length for approval):
- Yes
- No

Full Name*
Email
Phone*

(no dashes e.g. 5554443333)

Event Name
Address*
City*
State*
Zip Code:

(no dashes e.g. 555554444)
Special Directions to the Event:
Contact Name at Event:*
Contact Cell Phone Number at Event:*

(no dashes e.g. 5554443333)
Is the event open to the public?*
- Yes
- No
Will a meal be served?*
- Yes
- No
If the Commissioner is not available would another department representative be OK?*
- Yes
- No

Please indicate the type of appearance requested:*
- Appearance Only
- Keynote Speaker
- Welcome
- Brief Remarks
- Drop by
Exact Time of Speech:*
Time Allowed for Speech:*
Please let us know what topics are of interest to your group:
- Health Care
- Fraud
- Consumers and General Insurance Issues
- About the Oklahoma Insurance Department
- Other, please list below
Q&A Time:
Will there be other Speakers?:
Attire:*
Is there an LCD Projector, Screen and Laptop Available?*
- Yes
- No
Bio Requested?
- Yes
- No
Photo Requested?
- Yes
- No
Additional Information:
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Oklahoma Insurance Department 400 NE 50th Street, Oklahoma City, OK 73105 405.521.2828 | Business Hours: 8:00 AM - 5:00 PM

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