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Speaker Application

WELLtalks are held the third Tuesday of each month at the Downtown Cedar Rapids Library starting at 6pm. If you would like to present please fill out and submit this application.

Contact Information

Name

First Name

Last Name

Verify Email

Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Current Occupation

Education

Name of Proposed Talk

Synopsis of Talk (3-5 Sentences)

Speakers are Required to attend one WELLtalk before they present- When did you attend?

(mm/dd/yyyy)

Speaker Application

Contact Information

Thank you for your interest in presenting. Our programs committee will review your application and will contact you as soon as possible.