Program Information Form

This form is for meetings that are scheduled on either the 2nd or 4th Friday of the month. They are usually the regular Friday morning presentations or workshops and run from 8:00 a.m. to 9:30 a.m.

Please fill this form out completely to aid the Program Manager to schedule your meeting.

Note: Meetings on dates other than 2nd or 4th Fridays are scheduled using the Event Planning Form.

1st Choice Date (2nd or 4th Friday)

Month Day Year

2nd Choice Date (2nd or 4th Friday)

Month Day Year

3rd Choice Date (2nd or 4th Friday)

Month Day Year

Program Presenter(s) and Contact Information (for publicity - pictures/video/newsletter):

Presenter's Name

Please upload a photo from your files.

Email Address

Phone Number

I was referred by

(if applicable)

2nd Presenter's Name

Please upload a photo from your files.

Email Address

Phone Number

3rd Presenter's Name

Please upload a photo from your files.

Email Address

Phone Number

Please read our Speaker Guidelines. Hopefully, any questions you have will be answered --Thanks!

Program Title

Program Overview (for newsletter and website)

What three Key Learning Areas will your audience take away from your program?

Key Learning #1:

Key Learning #2:

Key Learning #3:

Please provide a short bio for the introduction (1 - 3 paragraphs)

Equipment needed for your presentation:

Projector Easel Both None (Zoom meeting)

Need any other equipment? Please specify.