Role/Speaker Registration

A huge THANK YOU for offering to share your talent, thoughts, and ideas with us! We are excited to have you!

If you haven't already, please like and follow our social media pages so we can get the word out about YOU!

Social Media

Phone

Email

346-577-1848

admin@thenixoninstitute.org

First Name

Last Name

Phone

Address

Do you plan to bring slides? Do you need any equipment? (We have mics and projector for use)

Not Applicable (not presenting)

I WILL bring slides, and need equipment (computer, thumb drive, etc)

I will NOT bring slides and do NOT need equipment (computer, thumb drive, etc.)

I WILL bring slides and my own equipment (computer, thumb drive, etc)

I will NOT bring slides, but still need other equipment

If I am unable to come, I will make a "best attempt" to find a comparable replacement and will notify organization staff in a timely fashion upon discovering a conflict with my scheduled date or time. I agree to refrain from using derogatory, discriminatory, or lewd content. I understand that I may share my views and opinions, but that they do not represent the views and opinions of the organization.

I have submitted the signed Social Media Consent Release Form to admin@thenixoninstitute.org.

Social Media Consent Release Form.pdf

Role/Speaker Registration

Social Media

Phone

Email

Thanks for submitting!