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Brown Bag Lunch Presenter Signup

Mandatory fields are marked with a red asterisk.
Name*
First Last
Business or Organization*
If you are not affiliated with a business or organization, enter: NONE
Address*
Street Address City State / Province / Region ZIP / Postal Code
Email*
Phone*
Alternate Phone
What is your preferred method of contact?*
- Email
- Phone
Title of Your Brown Bag Lunch Presentation*
This will be used in marketing. Please keep the title brief.
Description of Your Presentation*
Briefly describe your presentation (70 words maximum) This will be used for marketing purposes.
Desired Date*
Your first choice of a date to present.
Alternate Date(s) of Presentation if first choice is not available*
Optional - Upload your promotional photo
Maximum file size 3MB
Accepted file types: jpg, gif, png.
Is this a series or an event to repeat?*
If yes, we will contact you to schedule.
- Yes
- No
Tell us how you heard about the Brown Bag Lunch Series.
PLEASE NOTE: Please check that all mandatory fields are completed before submitting.
If you are not redirected to a confirmation page after clicking "Submit", WE HAVE NOT RECEIVED YOUR FORM. If your form is incomplete, you will be taken back to the top of the presenter registration page. Please scroll down to see errors marked in red.
Email
This field is for validation purposes and should be left unchanged.