Number of years experience in this field:

NJAWBO Chapter affiliation: Atlantic Bergen Burlington Camden/Gloucester Essex Hunterdon Mercer Middlesex Monmouth-Ocean Morris Ocean Passaic Somerset Sussex/Warren Union

How far will you travel? Miles Hours

Honorarium expected? Yes No

Travel Expenses expected? Yes No

Your Speaking Experience: Little Moderate Extensive

Program Categories
Please check overall category and explain below:

	Business Management and Legal Issues
	Entertainment and Recreation
	Environmental (Internal and External)
	Financial Issues
	Health and Food
	Home and Real Estate
	Image and Women's Issues
	Marketing
	Safety and Security
	Other

Please describe your prior speaking engagements:
Print this page and fax it to the appropriate chair. Don't forget to fax or mail your bio and/or resume. Thank you for your interest.

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