Speaker Registration

First Name*

Last Name*

Cell Phone*

Email*

Address - 1*

Address - 2

City*

NCSCOther

Zip*

YesNo

The online Member Directory is password protected and only contains name and email address of members. Phone and address information is not shown.

The directory can not be printed.

The password to access the directory is sent by the membership committee.

Website & Copyright Release

Permission to add to the Senior Scholars archives.

Website & Copyright Release

(Please read and choose one option below.)

I (the Presenter) am interested in making a presentation to a weekly membership meeting of Senior Scholars at Queens (SSQ). In submitting the information describing a proposed talk, I understand and acknowledge that SSQ has concerns regarding the inclusion in presentations prepared for or given to SSQ members by speakers of material the copyright to which is or may be owned by a party other than the Presenter. Presenter acknowledges that SSQ places a high priority on assuring that it possesses the right to post material on its website without violating others’ property rights. I understand that SSQ records each presentation if the speaker in question agrees to the recording. If I indicate below that I permit the recording and agree for SSQ to post the recording on its website, I understand that SSQ must assure itself of its right to do so without incurring liability for violating another’s copyright.

A. My presentation DOES NOT contain any images or other material in which another person has an ownership interest or, if another person has any ownership interest, I have the right to use that material and the right to permit SSQ to post the presentation on its website and I do hereby grant to SSQ permission to post my presentation on its website for subsequent viewing by members of SSQ or the public, in its discretion.B. My presentation DOES contain images or other material in which another person has an ownership interest, or I am uncertain as to whether it does. By selecting this response, I understand and agree that SSQ will not post my presentation on its website for subsequent viewing by members of the public, though it may, in its discretion, post the presentation on its website for a limited time for subsequent viewing by members of SSQ.C. I request that SSQ not record my presentation. By selecting this option, I understand that only members of SSQ who attend my presentation in person or remotely over the internet will ever see my presentation and its content.

Scheduled Dates:

Presentation & Q&A: Friday 9:30 - 11:30 AM @ Providence United Methodist Church (map), Wolfe Hall; ZOOM presentations can be arranged with Internet connectivity from the speaker's location.
Cell phone for Tech Support: Gordon Haymond (704) 577-4326.
The presentation's PowerPoint should be sent to SSaQ's dropbox on Monday; it is used as a backup. It is also shared with meeting moderators. Last minutes changes will be accommodated on the day of the presentation.
When presenting from a remote location, a Technical Check meeting is held on Monday 10 - 11 AM the week of the presentation. It is preferred that this location is used on Friday. If this time is inconvenient it will be rescheduled.

Presentation Date *

Confirm your presentation date.

Preparation Date

Only needed for ZOOM or remote speaker presentations.

Presentation Title*

Presentation Description*

Field expands by clicking X in the upper right-hand corner

Speaker's Title

Organization

Biographical Data or Resume*

Field expands by clicking X in the upper right-hand corner

resources for Members: websites and Books (optional).

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Preferred Photo

A honorarium is made to the speaker's charity of choice for $100.

If your organization does not allow a donation, please enter "None" for name and address.

Charity Name*

Charity Address & Website*

Street, City and Zip

Charity Email

YesNo

SpeakerNew Member

Status

Member Id

2021 Member

Date

Member Until

Giftcheck

NoYes