Tech Tips 411: Speaker Request Form
šš«šØšŸšžš¬š¬š¢šØš§ššš„ šƒšžšÆšžš„šØš©š¦šžš§š­/š’š©šžššš¤šžš« š‘šžšŖš®šžš¬š­
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šš„šžššš¬šž šœšØš¦š©š„šžš­šž š­š”šž šŸšØš«š¦ ššš§š šˆ š°š¢š„š„ šœšØš§š­šššœš­ š²šØš® ššš¬ š¬šØšØš§ ššš¬ š©šØš¬š¬š¢š›š„šž.
š…šžšžš¬ šÆššš«š² š›ššš¬šžš šØš§ š­š”šž š­š²š©šž šØšŸ šžšÆšžš§š­ ššš§š š„šØšœššš­š¢šØš§.
šƒš¢š¬š­š«š¢šœš­/šŽš«š ššš§š¢š³ššš­š¢šØš§: *
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šššš¦šž: *
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š“š¢š­š„šž: *
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š„š¦ššš¢š„: *
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šš”šØš§šž šš®š¦š›šžš«: *
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š‡šØš° šš¢š š²šØš® š”šžššš« ššš›šØš®š­ š‰šžš§š§š¢šŸšžš« š‡ššš„š„? *
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š“š²š©šž šØšŸ š’šžš«šÆš¢šœšž(š¬) š‘šžšŖš®šžš¬š­šžš: *
Please choose the service(s) that will help meet your needs. (Check all that apply)
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š“šØš©š¢šœ(š¬) š‘šžšŖš®šžš¬š­šžš: *
Be specific regarding topics you would like addressed. Is this a multi-day event?
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šššš¦šž šØšŸ š„šÆšžš§š­: *
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š„šÆšžš§š­ š‡ššš¬š”š­ššš :
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šƒššš­šž šØšŸ š„šÆšžš§š­ (šŸš¬š­ š‚š”šØš¢šœšž) *
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šƒššš­šž šØšŸ š„šÆšžš§š­ (šŸš§š š‚š”šØš¢šœšž) *
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š‹šØšœššš­š¢šØš§ šØšŸ š„šÆšžš§š­/š€ššš«šžš¬š¬: *
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š€š®šš¢šžš§šœšž: *
Indicate if the topic should be focused for a particular audience, i.e. administrators or teachers of a specific grade or subject.
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š€š®šš¢šžš§šœšž š‹šžšÆšžš„: *
š„š±š©šžšœš­šžš š§š®š¦š›šžš« šØšŸ š©ššš«š­š¢šœš¢š©ššš§š­š¬: *
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š€ššš¢š­š¢šØš§ššš„ š‚šØš¦š¦šžš§š­š¬:
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š’š®š›š¦š¢š­ š˜šØš®š« š‘šžšŖš®šžš¬š­:
The speaker fees vary and will depend on the options chosen above.

You may contact Jennifer directly with further questions at š­šžšœš”š­š¢š©š¬šŸ’šŸšŸ@š š¦ššš¢š„.šœšØš¦
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