FCA Conference Speaker Application

Thank you for your interest in participating at the FCA conference

All presenters must complete an application. If there are multiple speakers for one presentation complete the form and make sure the title of the presentation is the same. Presenters who are chosen will be sent an acceptance email. This could take until June 1st.

All presentations will need to be emailed to floridacertassociationinc@gmail.com prior to August 1st.

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* 1. Instructor Information

Name *

Company - CERT Name

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Email Address *

Phone Number *

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* 2. Course Title

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* 3. Course Description

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* 4. Instructor BIO

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* 5. Instructor Headshot

This photo could be displayed on our website or program.

PNG, JPG, JPEG, GIF file types only.

Choose File

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* 6. Qualifications for to teach this course:

Training

Experience

Teaching Background

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* 7. If you are chosen as a speaker for the FCA conference, it does not wave the fee of the conference or any other costs associated with attending. If you plan to be just a speaker you are allowed to attend only your session at no charge.

I understand that if I want to attend anything other than my presentation, I could be asked to pay the registration fee for the conference.