EXECUTIVE SPEAKER REQUEST FORM

Thank you for your interest in CPS Energy participating in your event! Requests must be submitted at least 60 days in advance of the proposed event/deadline date.

You will be contacted by a CPS Energy representative within 7-10 days after your request is received. Please complete all sections of this form.

 Appearance
 Speaker
 Presentation
 Roundtable
 Keynote
 Panel
 Publication

If requested Speaker is unavailable, would you be interested in an alternative Executive Speaker to participate?

Yes
No
requester information
event information
 Flexible Path
 New Energy Economy
 Smart Grid
 Simply Solar
 Energy Conservation
Yes
No
Yes
No
Yes
No

CPS Energy

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