Rotary Club of Walnut Grove, PO Box 81, Walnut Grove, CA 95690

Rotary Opens Opportunities 2020-2021

Rotary Club of Walnut Grove

Guest Speaker Application On behalf of our Rotary club, I would like to personally thank you for being our Guest Speakers. We look forward to your presentation. Please, take a minute and complete this form and return it 7-10 days prior to your speaking date.

Thank you, Kim Tranum, Program Director, Rotary Club of Walnut Grove.

Name and Vocation:

Speaking Date: ___________________________________

Log-In Time: 12:30

pm PST Access for Log-In will be emailed the Sunday before

What is Your Topic Headline with Brief Summary?:

Short Biography and Photo for Introduction:

In the space below or using additional paper, please provide

a short biography to be used as an introduction. _____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

Message for the President to Deliver:

What message from your presentation can our President strengthen: __________________________________________________________________________________________________________________________________________________________________________________________

Visual Content, Photo, Graphics, Social Media:

Please bring your presentation

- PowerPoint ready on a Flash Drive.

If you have any questions, let us know in advance

:_________________________________________________________________________________________________________________________________________________________________________________________

Permission to Use Your Bio, Photo, and Presentation:

As a guest of the Rotary Club of Walnut Grove, youunderstand the collection, storage and use of your information, biography, photos, and presentation may be used on our media platforms . Please type or e-sign your name as consent. Thank you!

Signature:

___________________________________________________

Date:

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Name: _____________________________________________________________________________________________

Vocation: _____________________________________________________________________________________________

Email Address: _____________________________________________________________________________________________

Mailing Address: _____________________________________________________________________________________________

__________________________________________________ST__________________Zip____________________

Telephone Number:

__________- _______________ - _______________________________________

After completion, please save this application as a PDF and email to: admin@WalnutGroveRotary.org

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