Washington State School Directors' Association
 

 
Speaker Change Form

 Final presenter details are due September 12.


 

CONTACTS:
For session information: Connie Lauderdale 360/252-3009
For A/V order information: Sue Brand 360/252-3016

Session ID # 

Session Title  
 

Session Contact:
Name 

Phone   

(w/area code)
Email 
 
  • If you are adding a new presenter, please include ALL of the information.
  • If you are removing a presenter, only the name is needed.
  • If you are correcting information, only the name and the correction are needed.
  • Note: The name, title and district/firm will be included in the printed program.
Change 1:
  Change:  remove this presenter    add this presenter   information/spelling correction
  Role:    Solo Presenter     Co-Presenter    Panelist    Moderator    Facilitator

First Name 

Last Name 
Title 

District/Firm 
Street Address 

City 

State 

Zip 
Phone (w/area code) 

Email 
Change 2:
   Change:  remove this presenter    add this presenter   information/spelling correction
   Role:    Solo Presenter     Co-Presenter    Panelist    Moderator   Facilitator

First Name 

Last Name 
Title 

District/Firm 
Street Address 

City 

State 

Zip 

 Phone (w/area code)  

Email 
Change 3:   
   Change:  remove this presenter    add this presenter   information/spelling correction
   Role:    Solo Presenter     Co-Presenter    Panelist    Moderator   Facilitator

First Name 

Last Name 
Title 

District/Firm
Street Address 

City 

State 

Zip 

  Phone (w/area code)  

Email 
Change 4:   
   Change:  remove this presenter    add this presenter   information/spelling correction
   Role:    Solo Presenter     Co-Presenter    Panelist    Moderator   Facilitator

First Name 

Last Name 
Title 

District/Firm 
Street Address 

City 

State 

Zip 

Phone (w/area code)   

Email 
Change 5:   
   Change:  remove this presenter    add this presenter   information/spelling correction
   Role:    Solo Presenter     Co-Presenter    Panelist    Moderator   Facilitator

First Name 

Last Name 
Title 

District/Firm 
Street Address 

City 

State 

Zip 

Phone (w/area code)   

Email 
Change 6:   
   Change:  remove this presenter    add this presenter   information/spelling correction
   Role:    Solo Presenter     Co-Presenter    Panelist    Moderator   Facilitator

First Name 

Last Name 
Title 

District/Firm
Street Address 

City 

State 

Zip 

Phone 

Email 

Click "submit" then print the confirmation page for your records.

 Copyright 2007 Washington State School Directors' Association

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