Speaker Request

We are happy to help. Please fill out the form below to make a formal request.

Note: All presentations must be approved by Executive Director and you will be notified pending approval.

Contact laurie@bpaa.com for questions

Contact Information
State Association / Organization
Name
Email
Phone
Area CodePhone Number
Event Information:
Event Name
Venue / Facility
City, State & Zip
Start Date and Time:
Month - Day - Year
Hour : Minutes
End Date and Time:
Month - Day - Year
Hour : Minutes
Event Website Address:
Number Of Attendees
Airfare and hotel will be paid by BPAA. Show and event registration paid by state.
Yes
No
Presentation Information
Datetime
Month - Day - Year
Hour : Minutes
Staff Member Requested:
Presentation Requested:
A/V will be provided (projector, screen, laptop, speakers, microphone, etc.:
Yes
No
Additional Information:
Additional Request:
Captcha

Month	-	Day	-	Year
Hour	:	Minutes

Month	-	Day	-	Year
Hour	:	Minutes

Month	-	Day	-	Year
Hour	:	Minutes

Contact Information