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Education & Training

Enhancing Your Personal Development
Interested in Being a Speaker or Presenter?

Complete the form below to be considered as a speaker or presenter for the California and Nevada Credit Union Leagues. (! required fields)

CONTACT INFORMATION
First Name:   !
Last Name:   !
Company:   !
Title:  
Address1:  
Address2:  
City:   !
State and ZipCode:  
Phone Number:  
FAX Number:  
E-mail Address:   !
     
PREVIOUS SPEAKING EXPERIENCE
At what size audience are you comfortable speaking? (select all that apply)   10-50 50-100 100-200 200+
Organization #1:  
Contact #1:  
Telephone #1:  
Organization #2:  
Contact #2:  
Telephone #2:  
Organization #3:  
Contact #3:  
Telephone #3:  
Biography:  
Speaking Topics:  
Please check the materials you will be sending:   Video of speech Outline of speech topics
Letters of reference
     
ADDITIONAL INFORMATION
What is your speaking fee?  
Will you speak without an honorarium?   Yes No
Will you absorb your travel and related expenses?   Yes No
If not, are you willing to travel on a restricted air ticket?   Yes No
From where are you traveling?  
Do you agree not to sell or promote your company's products during the session?   Yes No
What audio/visual equipment do you usually require?  
     
CONTACT PERSON OTHER THAN YOURSELF
Name:  
Address:  
City:  
State and ZipCode:  
Phone Number:  
FAX Number:  
E-mail Address:  
     

     
 

Please send your materials under separate cover to:
New Speaker Registration, Attn: Education and Training
California Credit Union League
P.O. Box 51476
Ontario, CA 91761-0076