Skip to content

KYACHW Conference Speaker Application

The Kentucky Association of Community Health Workers is pleased to announce their 7th annual conference scheduled for October 27th and 28th,  2022 at the Embassy Suites UK Coldstream in Lexington Kentucky. The theme for the conference is “We Can Be The Change” which reflects the impact that CHWs have on their communities. 

As a potential speaker please use this form to provide us with additional information regarding your proposed session. Selected speakers will be notified via email and may be asked to provided additional information.
1.What is your first name?(Required.)
2.What is your last name?
3.What is your title?(Required.)
4.What is your organization name?(Required.)
5.What is your organization address, city, state and zip Code(Required.)
6.Phone Number (Best number to reach you at)(Required.)
7.Email(Required.)
8.If you are selected to speak are you available?
9.Have you presented at a KYACHW conference before?(Required.)
Current Progress,
0 of 23 answered