The Blue Card Speakers Bureau Submission Form

The Blue Card Speakers Bureau Submission Form
Name*

First NameLast Name
Address:

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Email:
example@example.com
Phone Number:
Please enter a valid phone number.
Subject Matter Expertise:
Years of Professional Experience:
Certifications/Licenses:
Please tell us about your field of expertise. How does your background qualify you to join The Blue Card’s Speakers Bureau?
Please tell us about your personal connection to the Holocaust:
Speakers Fees:
Geographic Availability:
Available to travel:
Zoom Proficiency:

Novice = Require Technical AssistanceBeginner = Can navigate Zoom independentlyExpert = Can run presentations through screensharing and other tools
Should be Empty: