MNCPA Speaker Form

MNCPA Speaker Form
Full Name*

First NameLast Name
Agency*
Title*
Bio*
How would you like to be introduced? (a couple sentences)
E-mail*
Phone Number

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Session Title*
Topic*
Description of the Session*
Please describe your presentation for the program
MNCPA Provides:

LaptopProjectorScreenMicrophone (if venue allows)Computer SpeakersTable or PodiumOther
Speaker Provides:

I will use my own LaptopCopy of presentation (USB drive)Other
Note: please provide 25-50 additional copies of presentation materials
Please attach a copy of your resume here:

Upload a File
POST CERTIFICATION REQUIREMENT Cancelof
Do you plan to spend the night at the hotel
If yes, what night will you be staying
Additional Comments/Questions:
If you have additional questions or comments, let us know here.
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