EmailMe Form - 2024 PPG Webinar Submission Form

Name *

Prefix First Last Suffix

Email *

This email will be used to send your payment. Please i

The telephone number we can contact you on

### - ### - ####

International Phone number

Is this your first PPG webinar?

Yes

No

Are you proposing

A FREE member webinar

A paid member webinar

Not sure

Is this a webinar for

Pet Owners via Pets & Their People P&TP

Professionals via PPG

Business Name and Address *

Street Address City State / Province / Region Postal / Zip Code Country / Region

Business Website *

Please indicate when you would like to schedule this webinar

MM / DD / YYYY

Please allow a lead time of at least 8 weeks to post and market the event

Please indicate the time convenient for you to host this webinar and the time zone

We need to know what time zone you are presentign from so we list teh event accurately

Information About Your Webinar

Title for your webinar *

Please list a creative title to help market your webinar.

Have you presented to a professional audience before using online webinar technology *

Yes

No

Can you use Power Point or an equivalent software to present your webinar? *

Yes

No

Please select the key topic of your presentation *

If you selected "Specialized Topic" then please state what the topic is

Please detail the learning objectives for this webinar *

Please detail them as bullet points and as specifically as possible

Please indicate the level of this presentation and at what level of experience it is geared towards

Please describe your presentation in two paragraphs. The more details we have the easier it is to list and market the event *

Using no more than two paragraphs please give an overview of this presentation. What it is about

Please indicate the anticipated length of your presentation.

Presenter Photograph

If you are a presenter please upload a photograph of yourself.

Please attach a completed W9 form. The form can be found at http://www.irs.gov/pub/irs-pdf/fw9.pdf . Once the form is completed you can also fax it to us or email it to us.

USA residents only. Please download the file to your computer and save as and then upload here.

Your Professional Bio

Using two paragraphs please detail your bio, please be short and specific.

Checkbox *

I agree to the PPG terms & conditions of delivering a webinar to PPG members