If your group is interested in participating in a Speaker Exchange,
Please complete and submit the following form.

 

NOTE: This is an exchange of speakers between groups outside of the area.
Please do not submit a form if your group does not have a member willing to travel to other areas.

 


Group's Name:


Group's Address:


Exchange Meeting Day:


Exchange Meeting Date:


Exchange Meeting Time:


Meeting Format (Beginner,Step, Pamphlet,Topic,etc.):


Speaker Clean Time Requirements:


Speaker Exchange Rep. Info

Name:

Phone:

Email:


Other Group Particulars: