Due to the Covid – 19 pandemic, we are only able to accept invitations to virtual events.
Please use this form, but skip any travel details. ~ Thank you
Your Information _________________________
Your name
Organization Name
Your email
Phone
Mobile
Event Details _________________________
Host Organization
State AssociationRegional AssociationOthers
If other, please provide details below
Name of Event (please include a brief description)
Expected number of attendees
Event Start Date
Event End Date
Venue details
Speaker Details & Information _________________________
Requested length of time for the speaking engagement
Description
Additional Comments (optional)