2025 Membership Organizing Workshop RFP - Maryland State Education Association

Lead Presenter Name *

First

Last

Your training experience/comfort level

Selected Value: 1

EXPERIENCE Presenting to Adult Learners *

Specify organization presented to/for *

MSEA ID # *

Local Affiliation *

Personal Email *

Work Email *

Mobile Phone *

County *

Place of Work/Company *

Work phone *

Work address *

Address Line 1

Address Line 2

City

State

Zip Code

Home address *

Address Line 1

Address Line 2

City

State

Zip Code

Home Phone *

Race/Ethnicity *

Short Bio *

Gender *

Pronouns for Name Badge *

Self Description for Name Badge

Allergies

Please indicate if you have any environmental or food allergies that we should be aware of, e.g. nuts, dairy, gluten.

Will there be a second presenter with you? *

Yes
No

Co-Presenter Name

First

Last

Co-Presenter training experience/comfort level

Selected Value: 1

EXPERIENCE Presenting to Adult Learners (copy)

Co-Presenter – Specify organization presented to/for

MSEA ID #

Local Affiliation (Co-presenter)

Co-presenter Email

Co-Presenter preferred mailing address

Address Line 1

Address Line 2

City

State

Zip Code

Co-Presenter work phone

Co-Presenter home phone

Co-presenter mobile phone

Co-Presenter Short Bio

Co-Presenter Allergies

Please indicate if you have any environmental or food allergies that we should be aware of, e.g. nuts, dairy, gluten.

Accommodations and Special Requests

We are committed to providing an accessible event for all participants. If you require any accommodations due to a disability or have any special needs, please describe any necessary accommodations here or contact us directly to ensure that your needs may be met in this event. We will attempt to make every reasonable effort to accommodate your request.

A/V Policy

Video and sound recording is prohibited at MSEA events.