2023 FCP speakers bureau speaker application

Thank you for your interest! A few reminders below.

You must be classified as an active Academy member and a member of the FCP DPG for the past two years to be considered for the Speakers Bureau.

You can submit up to two topic proposals.

After completing this application, send a copy of your resume or curriculum vitae listing your previous speaking experience to the FCP Office (fcp@quidnunc.net).

Question Title

* 1. Have you been a member of FCP DPG for at least 2 years?

Yes

Unsure

Question Title

* 2. Please add your info.

Your name:

Academy #:

Your city:

Your state:

Email address:

Question Title

* 3. FCP anticipates that the funding for the speakers bureau (which will be paid directly to the speaker) will be up to $2,000 (combined travel and honorarium for an in-person event) and $500 (for a virtual event).
Is participating in the speakers bureau with these parameters still of interest?

Yes

Question Title

* 4. Please note which type of presentation is of most interest. (check all that apply)

In-person

Virtual

Question Title

* 5. If selected, please describe your preferred geographic location(s) for presentations.
Note: If selected as a speaker, your information will be included in the master speaker list. Affiliates/states (and possibly other Academy groups) will select their preferred speakers.

I would prefer to speak only close to my location.

I am willing to travel in my general geographic area.

I am willing to go anywhere.

N/A - I am willing only to speak virtually

Please add any details or information regarding your travel info.

Question Title

* 1. Have you been a member of FCP DPG for at least 2 years?

Question Title

* 2. Please add your info.

Question Title

* 3. FCP anticipates that the funding for the speakers bureau (which will be paid directly to the speaker) will be up to $2,000 (combined travel and honorarium for an in-person event) and $500 (for a virtual event).Is participating in the speakers bureau with these parameters still of interest?

Question Title

* 4. Please note which type of presentation is of most interest. (check all that apply)

Question Title

* 5. If selected, please describe your preferred geographic location(s) for presentations.Note: If selected as a speaker, your information will be included in the master speaker list. Affiliates/states (and possibly other Academy groups) will select their preferred speakers.

* 3. FCP anticipates that the funding for the speakers bureau (which will be paid directly to the speaker) will be up to $2,000 (combined travel and honorarium for an in-person event) and $500 (for a virtual event).
Is participating in the speakers bureau with these parameters still of interest?

* 5. If selected, please describe your preferred geographic location(s) for presentations.
Note: If selected as a speaker, your information will be included in the master speaker list. Affiliates/states (and possibly other Academy groups) will select their preferred speakers.