Formal name: [including any titles or designations]

Job Title or Role:

Title of talk:

Date of talk:
6-10 P.M.
(optional)

Contact Email:

Cell Phone #: [for emergency contact only]

Special Requests:

URL of your Personal website: (optional)

Bio details for presenting on the Whiff website:
I do NOT need to review and approve content before it is posted on the Whiff's website.

Image(s) for Whiff website - personal photo(s), book cover, etc.
Bio Photo:
Other:       
                 
                 

AV needed to accompany your talk::
(A Windows laptop with PowerPoint and a laser pointer are available for your use. The venue’s projector connection is an HDMI port)
No media needed for my talkI'll bring my own Windows laptop with an HDMI portI'll bring my own MacBook with an HDMI portI'll bring a memory stick with a PowerPoint presentation and use the venue's laptopOther -see bespoke requirements entered below

Guest's Name:

Dietary restrictions:

Charity to receive donation from The Whiff
as thanks for sharing your time with us:

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