Chicago NA Speaker Service Database
Enter  your information below and you will be added to the CSO's Speaker Database
Sign in to Google to save your progress. Learn more
Name *
Phone Number *
Email Address
How do you prefer to be contacted? *
What is your home area? *
Are you willing to speak at H&I meetings? *
What time of day are you typically available? *
Required
What days of the week are you typically available to speak? *
Required
What areas are you willing to travel to? *
Required
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Chicago NA. Report Abuse