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Julia Clukey
Presentation Request Form

 Olympian Julia Clukey signing autographs

The Maine Beer & Wine Distributors Association has partnered with Olympian Julia Clukey to be actively involved in the Association's responsibility initiative. The purpose of the initiative is to raise awareness about the importance of good decision making and responsibility. Julia's presentation focuses on her athletic career, personal decisions in life and the importance of individual responsibility. Since 2010, Olympian Julia Clukey has visited more than 20 schools across the state and reached more than 6,000 Maine students. This year, the MBWDA is again proud to partner with Julia on assembly presentations to spread our message of responsibility to students across Maine.

School Name: The presentation is sponsored by the MBWDA and is provided free of charge as part of their community involvement.
Requested by:
Title:
Address:
Phone:
Email:
Preferred contact: Phone: Email:
What time should we contact you?:
Desired Presentation
Date & Time:
Grade levels:
Estimated number of students:

In order to host a presentation we require the following:
Two microphones.
School representative or student that will introduce Julia as the presenter.
DVD player or video projector (must connect to a laptop that can play a standard DVD).
A presentation screen at least 8 feet tall (used to display the video introduction).
An audio visual person to be on site to address any potential technical issues (lights, speakers, etc.)


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