Program Speaker Idea Submission Form

Please fill out this form in entirety to submit any program speaker or topic idea.

Once submitted, this form will begin the process in which the program committee will vote to approve program ideas. If you have any questions, please reach out to the Rotary Office directly via email at [email protected].

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Your Name*
Who is submitting the proposal?
First Last
Email*
Phone
Speaker Name*
First Last
Company or Organization*
Position
Are you a Toledo Rotarian?*
- Yes
- No
- Rotarian from another Club
If Rotarian from other club, which club?
Toledo Rotarian that would vouch for you.
If you are not a Toledo Rotarian, please list a Toledo Rotarian that you know. Please note that as of April 15th, 2022, we do not allow self-submissions. You MUST be recommended by a current club member.
First Last
Title of Presentation
Speaker Topic:*
Please be specific on the topic; 50 words or less, please.
Has this speaker presented before at Toledo Rotary?*
- Yes
- No
- Unsure
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