Request A Copic Speaker

Please fill out the following form and a Copic representative will contact you.

Your Organization(Required)

Contact Person Name(Required)

Contact Person Email

Contact Person Phone

Desired Topic for Presentation(Required)

Format

In-Person

Virtual

Other

Physical Location for Presentation (if applicable)

Date of Presentation (if known)

Is Your Organization Currently Insured By Copic?

Yes

No

Other Information

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