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.

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Date of Your Program *

Program Coordinator You Are Working With *

Charles Woolever
Drew Saur
Denise Dickinson
Other

Other Coordinator *

Title of Your Program *

Your (the Speaker‘s) Name *

First

Last

Your (the Speaker’s) Title *

Your (the Speaker’s) Phone Number *

Your (the Speaker’s) Email *

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 *

Special Equipment Needed *

None (bringing my own)
Laser pointer
Table
Digital projector
Slide projector
Screen for projector
Presentation via Zoom
Other

Projector Support *

Mac
Windows PC
Linux PC

Other Equipment *

Featured Photo *

Click or drag files to this area to upload. You 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.

Speaker Honorarium Amount (Trad. $100) *

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

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Honeoye Falls – Town of Mendon Historical Society

© 1961–2022 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.

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