FPA NorCal 2026: Speaker Information

Information due by Friday, November 14, 2025

Full Name:*

First NameMiddle NameLast NameSuffix

First name as you desire it to appear on your name badge:*

Degree(s) (e.g., PhD) and Designations (e.g., CFP®):*

Company:*

Position Title:*

Can we publish your Full Name, Degree(s), Designation(s), Company, and Title?*

YesNo

Company Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Can we publish your Company Address?*

YesNo

Mailing address where correspondence should be sent (required if different from above):

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

CFP® # (if CE credits desired):

CRD # (if IAR CE credits desired):

CIMA®# (if CIMA® CE credits desired):

Company Website*

Email:*

example@example.com

Office Phone Number*

Please enter a valid phone number.

Cell phone:*

for internal use only, NOT published

Can we publish your Company Email and Office Phone Number?*

Yes, both.No, neither.Email not phone.Phone not email.

Please enter your BUSINESS Social Media:

	Business Page URL
LinkedIn
Facebook
Instagram
Other

Can we publish your social media links?*

YesNo

Would you like to provide contact information for additional staff?*

AssistantSpeakers' Bureau ContactNone

Name

First NameLast Name

Email

example@example.com

Title

Company

Office Number

Please enter a valid phone number.

Cell Number

Please enter a valid phone number.

Name

First NameLast Name

Email

example@example.com

Title

Company

Office Number

Please enter a valid phone number.

Cell Number

Please enter a valid phone number.

Please upload a head shot image to appear with biography*

Head shots must be no less than 800x800 px, must be in JPG or PNG format, and should be a photo taken from the shoulders up

Enter biography copy here:*

0/200

Are you the only speaker presenting this session?*

Yes, I am presenting alone.No, I am presenting with other speakers.

Please provide the name(s) of the other speaker(s) you are presenting with:*

Presentation Title*

100 character max including spaces

Presentation Description*

0/200

Level of Complexity*

IntermediateAdvanced

Learning Objectives (necessary for submitting for CE Credit approval)*

I am available to speak Tuesday May 26, 2026*

YesNo

I am available to speak Wednesday May 27, 2026*

YesNo

I give my permission to have my presentation/workshop professionally audio recorded at the 2025 FPA NorCal Conference at The Palace Hotel, taking place on Tuesday, May 26, and Wednesday, May 27, 2026.

I understand that the audio recording, with video of my PowerPoint slides, will be uploaded to the FPA NorCal website, www.FPANorCal.org. ONLY conference registrants and speakers will have access to this recording, from mid-June through the end of August 2026. The audio and other materials will never be made available for sale or distributed in any other way.

I am aware that people in the audience may tweet about my presentation and press in attendance may quote me. Attendees will not be permitted to record the presentation by audio or video.

I have the right to request removal of the recording of this presentation from the FPA NorCal website at any time, for any reason, with a request sent via email to the Conference Director. FPA NorCal agrees to comply with my written request within two business days.

Signature*

Printed Name*

Speaker Information Form

Information due by Friday, November 14, 2025

Speaker Contact Information

Continuing Education Information

Additional Contact Information

Additional Contacts

Assistant Contact

Speakers' Bureau Contact

Speaker Biography

Presentation Info

AUDIO RECORDING RELEASE