Speaker Registration

Thank you for giving your time to present to a meeting of the Rotary Club of Fremantle. Please read through the information sheet here and then complete the following registration / checklist so we can ensure everything goes smoothly for your presentation.  Thanks.

Speakers Name (required):
Speakers Topic (required):
Date of Talk (required):
Email (required):
Mobile (required):
Dietary Requirements:
Guests/ Guests Dietary Requirements:
Laptop Required: YesNo
Projector Required: YesNo
Laptop Speaker Required: YesNo
Lectern Required: YesNo
Optional very short description of your presentation for promotional purposes:
Optional Image for Promotional Purposes (Maximum 2mb):
Anything Else?: