SPEAKER INFORMATION SURVEY

Please complete this survey if you are interested in speaking at a meeting or event for chapters in the Pacific Region.  Your information will be placed in the ARMA Pacific Region Speakers Bureau Directory and will be available through this website to the ARMA chapters in the Pacific Region.

Download Current Speaker's Directory [PDF]

Please indicate if this is a NEW or UPDATED form:  New    Update
(Please complete all fields for either choice)

To be removed from the Speaker's Bureau, please email webmaster@armapacific.org

Personal Information
Name:
Organization:
Address:
City: State/Zip 
  (Please be sure to include your area code)
Telephone: Fax:  Cell: 
Email:
To which ARMA Chapter(s) do you belong?
 
 
 
 

Speaking Preferences
Please check all chapters where you are willing to speak. Check all
  Central Calif/Bakersfield Central Coast Golden Gate
  Greater Los Angeles Hawaii Mt. Diablo
  Orange County Arizona (Phoenix) Sacramento
  San Diego Sierra Nevada Silicon Valley
  Silver State Utah/Salt Lake Upland/Inland Empire
Tucson
Would you require the host chapter to cover expenses?  
  None
Airfare     Hotel     Rental Car     Meals    Other:
Would you accept an honorarium?   Yes      No      Donation to AIEF or other charity in my name

What topics are you interested in presenting?
Please list ARMA chapters or other organizations where you have spoken:

Organization Name
 City, State
Contact Name
 Phone Number
Organization Name
 City, State
Contact Name
 Phone Number
Organization Name
 City, State
Contact Name
 Phone Number
Short Bio (250 words max)

By clicking submit, you are consenting that the information provided may be displayed on the ARMA Pacific Region website.

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