PSMS 278 Career Day Guest Speaker Registration Form (2017-2018)
Please fill out the form below if you plan to be a speaker at Career Day on Wednesday, January 24th, 2018
Contact Information
Name *
First and Last Name
Your answer
Primary Phone *
Your answer
Secondary Phone
Your answer
Email *
Your answer
Address *
Your answer
Guest Bio
Tell us about you!
Job Title *
Your answer
Company/Employer *
Your answer
Your answer
Job Description / Bio *
Tell us about your background, education, interests, and career. We have bio’s on file for 2015-2016 participants; please indicate “on file” below if you would like us to use.
Your answer
Guest Preferences
Speaking Schedule *
Please indicate in the check boxes below Full Day, Half Day, or the specific periods of time you are available. Speakers will only be scheduled for the number of sessions requested and if you indicate “available” for back-up support. Indicating your full range of availability between 8:00 am and 2:14 pm is helpful to scheduling.
Number of Sessions *
Please indicate approximate number of sessions. Both breakfast and lunch hospitality will be available to keep you energized!
Back-up Support *
Please indicate if you are available as to act as back up speaker (in the event a scheduled speaker is sick or cancels) after your session(s).
Classroom Requests
Please indicate if there is a specific class you would like to address as part of your speaking schedule. Please note the best effort will be made to match speakers with class requests.
Grade Preferences *
Below please indicate your grade preferences. Please note approximate class size is indicated for guests planning to bring materials to work with or hand out to students.
Special Requests, Questions, Other Technology
Your answer
AV/ Technology/ Presentation Needs
Check all boxes that apply
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