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I'm a speaker; please consider me
for the 2012 Conference.

Speaker Name
Prefix First Name Last Name Suffix

Speaker Contact Info
Phone
E-mail
Street Address
City/State/Zip
Website

Topic Expertise
Title 1
Description 1
Title 2
Description 2
Title 3
Description 3
Title 4
Description 4
Title 5
Description 5

Experience
Link(s) to a video of you presenting to an audience



Rate for 90-minute session to ~ 200 attendees
Upload Biography
Upload Photo
List prior PAHCOM Annual Conference experience
List prior PAHCOM Chapter experience

References
Name E-mail Phone Letter of Recommendation

Availability
I'm available October 16 - 18, 2012: