UMKC CommUniversity Online Class Registration

Wholistic Health Fair Speaker Form


Twenty 45-minute lectures will be selected from the applications we receive. Preference will be given to those who have reserved a booth.


* indicates required field
Company Name*  
Wholistic Service
Contact Person*  
Address*  
City*  
State*
ZIP*    
Phone Number* (xxx-xxx-xxxx)  
Email*    
My topic*
Speaker's Name*
Brief Speaker biography
 characters remaining.
Description of Lecture*
 characters remaining.
Do you need any AV Equipment?*
If yes, Please Describle what you need
What time? Please choose 3 possible times.
First Choice
Second Choice
Third Choice

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