Virtual National Officer Request Form

National Officer Virtual Request Form
Chapter/State/Organization Name*
State *
Contact Name*

First NameLast Name
Contact Email *
example@example.com
Contact Cell Phone Number *

Area CodePhone Number
What type of virtual event are you interested in?*
Other: Please describe.
Will this request be delivered live virtually or recorded?*
*PLEASE NOTE - We will not be able to provided a recorded workshop - they must be live virtually.
Please provide the preferred date of the live virtual event, if flexible - leave blank:

MonthDayYear
Date
Please provide the preferred start time of the live virtual event, if flexible - leave blank:

:HourMinutesAM/PM Option
In what time zone is this event taking place? *
Length of the live virtual event:*
Example - 30 minutes, 1 hour, etc
Please provide the due date for the recording, if flexible - leave blank:

MonthDayYear
Notes/Other information:

National Officer Virtual Request Form