Speaker List Request Form

Speaker List Request Form
Only those who hold Secretary or Group Rep service positions for your meeting can submit a Speaker List Request Form. Please honor the anonymity of our speakers; do not share this list outside of your meeting.

Note that the District does not screen speakers, nor is it a recommended list of speakers; meetings are responsible for screening speakers to ensure they meet expectations and qualifications. If applicable, any travel mileage (at the current non-profit rate) must be negotiated and paid by the meeting.
Name*
First Name, Last Initial
Email Address*
Phone Number*
Format: (000) 000-0000.
YesNo
WSO ID Number*
Meeting Name*
Meeting City*
Meeting Day*
Meeting Time*
SecretaryGroup Representative
Who is your meeting’s Group Representative? (if self, please state)*
Please verify that you are human*
Should be Empty: