๐Ÿ’ป Tech Tips 411: Speaker/PD Request Form
๐๐ซ๐จ๐Ÿ๐ž๐ฌ๐ฌ๐ข๐จ๐ง๐š๐ฅ ๐ƒ๐ž๐ฏ๐ž๐ฅ๐จ๐ฉ๐ฆ๐ž๐ง๐ญ/๐’๐ฉ๐ž๐š๐ค๐ž๐ซ ๐‘๐ž๐ช๐ฎ๐ž๐ฌ๐ญ ย 
๐“๐ก๐š๐ง๐ค ๐ฒ๐จ๐ฎ ๐Ÿ๐จ๐ซ ๐ฒ๐จ๐ฎ๐ซ ๐ข๐ง๐ญ๐ž๐ซ๐ž๐ฌ๐ญ. ย 
๐๐ฅ๐ž๐š๐ฌ๐ž ๐œ๐จ๐ฆ๐ฉ๐ฅ๐ž๐ญ๐ž ๐ญ๐ก๐ž ๐Ÿ๐จ๐ซ๐ฆ ๐š๐ง๐ ๐ˆ ๐ฐ๐ข๐ฅ๐ฅ ๐œ๐จ๐ง๐ญ๐š๐œ๐ญ ๐ฒ๐จ๐ฎ ๐š๐ฌ ๐ฌ๐จ๐จ๐ง ๐š๐ฌ ๐ฉ๐จ๐ฌ๐ฌ๐ข๐›๐ฅ๐ž. ย 
๐…๐ž๐ž๐ฌ ๐ฏ๐š๐ซ๐ฒ ๐›๐š๐ฌ๐ž๐ ๐จ๐ง ๐ญ๐ก๐ž ๐ญ๐ฒ๐ฉ๐ž ๐จ๐Ÿ ๐ž๐ฏ๐ž๐ง๐ญ ๐š๐ง๐ ๐Ÿ๐จ๐ซ๐ฆ๐š๐ญ (virtual or face-to-face).
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๐๐š๐ฆ๐ž: *
๐“๐ข๐ญ๐ฅ๐ž: *
๐ƒ๐ข๐ฌ๐ญ๐ซ๐ข๐œ๐ญ/๐Ž๐ซ๐ ๐š๐ง๐ข๐ณ๐š๐ญ๐ข๐จ๐ง: *
๐„๐ฆ๐š๐ข๐ฅ: *
๐๐ก๐จ๐ง๐ž ๐๐ฎ๐ฆ๐›๐ž๐ซ: *
๐‡๐จ๐ฐ ๐๐ข๐ ๐ฒ๐จ๐ฎ ๐ก๐ž๐š๐ซ ๐š๐›๐จ๐ฎ๐ญ ๐‰๐ž๐ง ๐‡๐š๐ฅ๐ฅ (Tech Tips 411) ? *
๐“๐ฒ๐ฉ๐ž ๐จ๐Ÿ ๐’๐ž๐ซ๐ฏ๐ข๐œ๐ž(๐ฌ) ๐‘๐ž๐ช๐ฎ๐ž๐ฌ๐ญ๐ž๐: *
Please choose the service(s) that will help meet your needs. (Check all that apply)
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๐’๐ž๐ฌ๐ฌ๐ข๐จ๐ง(๐ฌ) ๐‘๐ž๐ช๐ฎ๐ž๐ฌ๐ญ๐ž๐: *
Select one or more sessions. Don't see your topic, I am happy to create a custom session.
Required
๐๐š๐ฆ๐ž ๐จ๐Ÿ ๐„๐ฏ๐ž๐ง๐ญ: (if applicable)ย 
๐„๐ฏ๐ž๐ง๐ญ ๐‡๐š๐ฌ๐ก๐ญ๐š๐ : (if applicable)ย 
๐ƒ๐š๐ญ๐ž ๐จ๐Ÿ ๐„๐ฏ๐ž๐ง๐ญ (๐Ÿ๐ฌ๐ญ ๐‚๐ก๐จ๐ข๐œ๐ž) *
MM
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DD
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YYYY
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๐ƒ๐š๐ญ๐ž ๐จ๐Ÿ ๐„๐ฏ๐ž๐ง๐ญ (๐Ÿ๐ง๐ ๐‚๐ก๐จ๐ข๐œ๐ž) *
MM
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DD
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YYYY
Time
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๐‹๐จ๐œ๐š๐ญ๐ข๐จ๐ง ๐จ๐Ÿ ๐„๐ฏ๐ž๐ง๐ญ - ๐€๐๐๐ซ๐ž๐ฌ๐ฌ or (Zoom, Meet, Teams): *
๐€๐ฎ๐๐ข๐ž๐ง๐œ๐ž: *
Indicate if the topic should be focused for a particular audience, i.e. administrators or teachers of a specific grade or subject.
๐€๐ฎ๐๐ข๐ž๐ง๐œ๐ž ๐‹๐ž๐ฏ๐ž๐ฅ: *
๐„๐ฑ๐ฉ๐ž๐œ๐ญ๐ž๐ ๐ง๐ฎ๐ฆ๐›๐ž๐ซ ๐จ๐Ÿ ๐ฉ๐š๐ซ๐ญ๐ข๐œ๐ข๐ฉ๐š๐ง๐ญ๐ฌ: *
๐€๐๐๐ข๐ญ๐ข๐จ๐ง๐š๐ฅ ๐‚๐จ๐ฆ๐ฆ๐ž๐ง๐ญ๐ฌ:
๐’๐ฎ๐›๐ฆ๐ข๐ญ ๐˜๐จ๐ฎ๐ซ ๐‘๐ž๐ช๐ฎ๐ž๐ฌ๐ญ:
The Speaker/PD fees vary and will depend on the options chosen above.

You may contact Jen directly with further questions at ๐ญ๐ž๐œ๐ก๐ญ๐ข๐ฉ๐ฌ๐Ÿ’๐Ÿ๐Ÿ@๐ ๐ฆ๐š๐ข๐ฅ.๐œ๐จ๐ฆ
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