Presenter Application Form

Presenter Application Form

Presenters receive $100 per class, meals, and full weekend access. www.circleupgathering.com
Name*

First NameLast Name
Address

Street Address

Street Address Line 2

CityState

Zip CodeCountry
E-mail*
example@example.com
Phone Number*
Format: (000) 000-0000.
Class or Workshop Title:
Description of your offering
(what participants can expect)
Short Bio:
Please do not exceed 200 words.
send the $100 back into the scholarship pool
Upload photos for Bio and workshop*

Cancelof
Signature
Should be Empty: