Speaker Registration Information
Annual Meeting Speaker Registration
*
Required Field
*
First Name:
Last Name:
Official Title:
Organization:
*
Address:
Address 2:
*
*
*
City:
State:
Zip:
*
Phone
*
Email:
Website:
No additional AV
Power Point Presentation
DVD Player
Overhead Projector
Easel, pad and markers
Internet Connection
Other
Indicate your Audio/Visual Needs:
You will have a microphone and podium.
Please use control-click to
highlight more than one, if needed.
Do you give permission for your Power
Point Presentation to be posted to our
website as a PDF?
(choose one)
Yes
No
Not Attending
Beef
Chicken
Vegetarian
Gluten Free
Thursday Evening Banquet Preference:
(choose one)
Just attending the day I speak
Attending the entire meeting
Your Attendance
(choose one)
If you are only attending the day you speak, your registration is complimentary. If you are attending
additional days, we ask that you pay for your registration. Also, some speakers pay the registration fees
as a way to support Four States Irrigation Council.
This registration is for speakers only.
