Speaker Questionnaire

This questionnaire is designed to help us prepare a program that is specifically tailored to the needs of your group. Please answer all the questions, and return the form to our office. Fax 561-775-4580 Thank You.

Special Request; Please send me as much information as possible to help increase my understanding of your organization. This includes website links, newsletters or other information you feel would be of value.

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Audio/Visual guidelines please Click here to Download.

  • Event Information

  • Organization Information

  • Logistical Information

    Provide the name and contact information of the person responsible for handling logistics:

  • Products

    Rita has books and items that are available for purchase. She would welcome the opportunity to provide products so that the participants have something to take with them.