Seminar Speaker Form
Planning of making a presentation at the Convention? Then please fill out this form, electronically, as handwritten forms will not be accepted. Thank you for your cooperation! You should be able to fill out the form by started with your email address. When completed, press the "Submit" button at the bottom of the page.
Email address *
PGI Speaker Form
Name of Presenter (as you would like it to appear) *
Your answer
Presenter's Address *
Your answer
Presenter's Home Phone
Your answer
Presenter's Cell Phone (for you on site) *
Your answer
Is this Seminar New or a Repeat? *
Title of Your Seminar/Workshop *
Your answer
Description of Course *
Your answer
Instructor Biographical Information *
Your answer
Seminar or Workshop? *
Maximum # of Participants (attendance may be limited by room size *
Required
Will you be working with live material(1.3 or 1.4) *
Day, time and duration Preferences
Your answer
Could you repeat the course or workshop at Convention *
Audiovisual Equipment Required *
Required
Additional Needs?
Your answer
May the Course be Recorded? *
Fees for Participants? Cost per person *
Your answer
Do you want to support pre-registration? Only valid for fee-based course or those with limited enrollment *
Preparation Needs and Time Required before you begin.
Your answer
Submit
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