Speaker Information Form

Speaker Information Form

Please submit info for your speaker profile sheet. This information will be shared with NARPM Chapter Leaders to contact you for meetings and event presentations. This information will also be visible on our Chapter Library Speaker Page.
Speaker Name

First NameLast Name
Designations/Credentials
Email
example@example.com
Phone Number
Please enter a valid phone number.
Website URL
Facebook Profile URL
Twitter Profile URL
Linkedin Profile URL
Instagram Profile URL
Speaker Bio
Describe the presentations you offer.
Title of Presentation 1
Description of Presentation 1
Title of Presentation 2
Description of Presentation 2
Locations you serve or will travel to
Bio or Contact Sheet Upload

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Headshot Upload

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Logo Upload

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What type of presentations do you provide?

Legal or LegislativeTechnicalMotivationalInsuranceHousingSupport AnimalsBusiness DevelopmentPanel DiscussionsMaintenance
I would like to be included in the speaker library

YesNo
By submitting this form,I agree to have my photo and bio on the Chapter Pilot website if I selected Yes above. https://chapterpilot.com/speakers-bureau
Should be Empty: