Survivor's Speaker Bureau Training Registration

Name(Required)

First Last

Phone

Email(Required)

Chapter Affiliation:

Are you available to attend the training on Thursday April 14 from 5:30-8:30p.m.?(Required)

Yes, I am available to attend training on Thursday April 14 from 5:30-8:30p.m.

I am unavailable but would be interested in future trainings.

The training is scheduled for Thursday, April 14 from 5:30-8:30pm. Dinner will be provided. Space is limited initially, but we will work to identify opportunities for participation in the speakers bureau for any member interested.

Do you have any dietary restrictions?(Required)

Do you have any questions?

Additional information about the program will be sent to participants via email.

Survivor’s Speaker Bureau Training Registration