Request to speak at the general meeting
Please fill out the form below to inform the HIP Board of the topic you wish to discuss at the upcoming general meeting.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Proposed Topic Description
*
Please describe if and what technology is needed for your presentation.
Preferred Date for Presentation
*
-
Month
-
Day
Year
Date
Would you like to receive updates about the meeting?
Yes, please keep me informed
Signature to Confirm Submission
*
Submit Request
Submit Request
Should be Empty: