Please enable JavaScript in your browser to complete this form.
CEPA Event FAA Safety WINGS Event and Speaker Information Form
Please enter the event and speaker information into the form below. We meet in a double-size classroom with capacity for about 60 people. The room has a modern audiovisual system. It has a cable with an HDMI plug; if you need a different connection or would like us to provide a laptop, please be sure to specify it in the comments at the end. Thank you for participating in our Safety Program!
Please enable JavaScript in your browser to complete this form.
Speaker name:
*
Speaker email address:
*
Speaker phone number:
*
Event Date / Time
*
Date
Time
Event Name:
*
Event Topic (Teaser):
*
85 characters maximum
Event Description (long):
*
The FAASafety.gov website allows a combined length of Event Description plus Speaker Bio has a maximum of 863 characters and must contain no more than 9 paragraphs. For our CEPA website, you may use more characters and paragraphs, but when posting the event on FAASafety.gov, it will be reduced to fit.
Speaker Biography:
*
Speaker Bio Picture:
*
Drag & Drop Files,
Choose Files to Upload
Please provide a picture of yourself in one of the following formats: .png, .gif, .jpg, .jpeg, .bmp, .tif
Comments or special equipment requested:
By completing this form, you consent to allowing us to take pictures and/or videos during and publish them.
*
I consent
I do not consent
Email
Submit
Scroll to Top
