Program Committee Speaker Form

Please fill out this form so that the Honeoye Falls-Town of Mendon Historical Society Program Committee can prepare for your speaking visit. Thank you for offering to speak during our program night.

Please enable JavaScript in your browser to complete this form.

Program Coordinator You Are Working With *

Charles Woolever
Drew Saur
Denise Dickinson
Other

Other Coordinator *

Date of Your Program *

Please enter the date agreed upon with your Program Coordinator from the Society.

Title of Your Program *

Your (the Speaker‘s) Name *

First

Last

Your (the Speaker’s) Title *

Please enter your professional title, if any, that we can use alongside your name when promoting the event.

Your (the Speaker’s) Phone Number *

This will be used for communication with you and will not be shared with the public.

Your (the Speaker’s) Email Address *

This will be used for communication with you and will not be shared with the public.

Short biography, to be used in promotional materials as well as the evening's introduction *

A summary of what the program will cover, to be used in promotional materials *

You may enter multiple paragraphs, if desired.

Special Equipment Needed *

None (I'm bringing everything I need)
Laser pointer
Table
Digital projector for computers
35mm slide projector
Screen for either type of projector
Presentation via Zoom
Other

THREE NOTES: 1) Unless otherwise noted and/or you specify "Presentation via Zoom" above, all programs are hosted at the Mendon Community Center, 167 North Main St., Honeoye Falls NY 14472. 2) We generally open the Community Center at 7PM to allow 30 minutes of setup and prep for all on-site presenters. 3) On-site presenters with computer-based presentations are expected to bring their own computer; we have cables to connect your computer to our digital projector if you request that option.

Projector Support *

Mac
Windows PC
Linux PC

Other Equipment *

Featured Photo *

Drag & Drop Files, Choose Files to UploadYou can upload up to 2 files.

Please upload a photo to be featured at the top of the Facebook event we post. Recommended to be landscape, rectangular.

Are you willing to have this program recorded? *

Yes, for the Historical Society YouTube Channel
Yes, only for Historical Society archives
No

Speaker Honorarium Amount (Trad. $100) *

To whom the Historical Society’s Honorarium check should be made payable *

Address for Mailing Honorarium Check *

Address Line 1

Address Line 2

City

State

Zip Code

↑

Honeoye Falls – Town of Mendon Historical Society

© 1961–2025 Honeoye Falls - Town of Mendon Historical Society. All rights reserved. The Honeoye Falls - Town of Mendon Historical Society is a 501(c)(3) nonprofit organization, EIN 20-4502970. Donations are tax-deductible.

Visit us on Facebook and YouTube!