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Speaker Request Form

1. Please fills out the information according to who will be the point of contact.

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Name:

 

 

 

     

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If you respond and have not already registered, you will receive periodic updates and communications from YWCA York.


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Question - Required - Please indicate what type of presentation you would like.
Please make 1 selection from the choices below.

*9.
Question - Required - Please indicate what type of materials you would like us to bring.
Please make between 1 and 17 selections from the choices below.

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*17.
Question - Required - Will the following equipment be provided?
Please make between 1 and 6 selections from the choices below.

   Please leave this field empty