MHAH - Mental Health Association of the Heartland

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):
	Professional Continuing Education Community Education
Availability:
	Weekdays Evenings Weekends
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: