WMPPD Presenter Application 2017
PLEASE NOTE THAT APPLYING DOES NOT GUARANTEE ACCEPTANCE. YOU WILL HEAR FROM THE COMMITTEE SOON AFTER YOUR APPLICATION ABOUT OUR SELECTION PROCESS.
Legal Name *
Your answer
Mailing Address *
Your answer
City *
Your answer
State *
Two-letter state code
Your answer
Zip Code *
Your answer
Phone Number *
Your answer
Cellphone *
Your answer
Magickal or Preferred Name for Program Book *
(if accepted)
Your answer
Email address *
Your answer
Website
Your answer
Title of Presentation *
Your answer
What kind of presentation is this? *
In 75 words or fewer, please describe the presentation. *
Your answer
In 75 words or fewer, please include a biography to be used in the program book if your presentation is accepted. *
Be sure to include what makes you qualified to make this presentation.
Your answer
Is there a co-presenter? *
If there is a co-presenter, please use this space for her/his biography in 75 words or fewer.
Your answer
Optional: Are there any other comments you wish to offer to the committee as we review applications?
Your answer
Western Mass Pagan Pride Code of Conduct: Signature *
Read the Code of Conduct below this form. By digitally signing here, you agree to abide by all the terms listed above in the Code of Conduct, and that you agree to the "no refund" policy for vendor fees.
Your answer
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