FPA Central Ohio Speaker Interest Form

Thank you for your interest in presenting to FPA of Central Ohio! Please fill out the information below, so we can review your request.

Speaker Information:

Name:
Organization:
Phone:
Email:
Speaker Qualifications (Select all that apply):
Academic Degree
Industry Credentialing
5 or more years of experience in field related to topic

Presentation Information:

Program Title (up to 40 characters):
Brief program description
(up to 10 full sentences)
Learning Objectives(3 required):
1.
2.
3.
Has this program been approved for CFP in the past? (If yes, please provide Course ID):
YES
NO
Course ID:
Speaker Fee:
Do you require FPA cover travel costs?
YES
NO
   - denotes required fields