NAGC Webinar Presenter Interest Form

Presenter Information

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* 1. What is your name?

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* 2. Contact Information

Company

Address

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

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* 3. Biography: Please tell us about yourself.

Note: if you are selected, this text will be used on NAGC's website and email promotions

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* 4. Upload your photo.

This will not be used during the application review process but will be used on NAGC's website and in email promotions if your proposal is selected.

PNG, JPG, JPEG file types only.

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* 5. Are you an NAGC member?

This does not affect the status of your application.

Yes

No

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* 6. Why do you want to present a webinar with NAGC?

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* 7. Please let us know which month(s) you are available to present.

NAGC webinars take place on the third Wednesday of every month from 1:00 - 2:00pm ET.

	Yes	No	Maybe
January	January Yes	January No	January Maybe
February	February Yes	February No	February Maybe
March	March Yes	March No	March Maybe
April	April Yes	April No	April Maybe
May	May Yes	May No	May Maybe
June	June Yes	June No	June Maybe
July	July Yes	July No	July Maybe
August	August Yes	August No	August Maybe
September	September Yes	September No	September Maybe
October	October Yes	October No	October Maybe
November	November Yes	November No	November Maybe
December	December Yes	December No	December Maybe