Speaker's Bureau Reimbursement Request Form For State Associations
All state associations who go through the NAA for a speaker for their conventions will receive a reimbursement up to $600 for speakers. Please allow up to three weeks for checks to arrive.
Association Name
*
Event
*
Full Name
*
Email
*
example@example.com
Speaker Name
*
Who should check be made out to?
*
Address check will be sent to:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Receipts
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Total you are requesting:
Max: $600
How many attendees joined the NAA or received a complimentary membership at this event?
*
How would you rate the speaker’s effectiveness? Did the speaker meet the event's objectives? Please share any specific feedback or recommendations for improvement.
*
List of attendees and email addresses
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Signature
*
Submit
Should be Empty: