Mental Health Associaton of the Heartland
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Speaker's Bureau: Volunteer to Become a Speaker

MHAH's Speaker's Bureau provides workshops, seminars and speaking presentations to business, social services, community and other groups.

To volunteer as a member of the Speaker's Bureau, to give presentations on behalf of MHAH, complete this form and click on "Submit." For additional information or questions, call (913) 281-2221.

Information in red is required.

Indicate the type of workshop or speaking presentation you would like to provide (check all that apply):
  
Availability:
  
  
Topic(s) you'd like to present:
Target audience you wish to present to:
Experience:
Personal
Professional


Name:
Degree
Address:
City:
State:
Zip:
Phone:
Fax:
Email :
Employer:

How did you hear about us?
Additional comments or questions:

    




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