Connecticut Department of Labor
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Department of Labor Speakers' Bureau Request Form

Once you have submitted your request, a Department of Labor Representative will contact you
to confirm the availability of a speaker for the date and time you have requested.

Contact Name:
Phone Number:  
Fax Number:
Email Address:
Organization Address:


Topic Requested:
 (select topic using drop-down arrow above)

*Note: Please call Stephen Dombrowski at (860) 263-6051 to request other topics than those listed above.

Event Date:
Event Time:      AM  PM
Event Location:
Audience Count:   **(a minimum of 25 attendees is required)**



200 Folly Brook Boulevard, Wethersfield, CT 06109 / Phone: 860-263-6000

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