Thank you for agreeing to be a speaker for the 68th Annual Wisconsin Student Nurse's Association Convention being held February 3-5 2016 at the Wilderness Resort  in Wisconsin Dells, WI.  Please take a moment to fill out the following Speaker Agreement Form so that we may have your information ready when you arrive.  Thank you for your time. 

Address *
Phone *
This will be used by the Board of Directors for the website as well as to introduce you to the group to whom you are speaking.
*Equipment must be indicated on or before January 13, 2017 to guarantee equipment availability.
Dates you are available to speak: (Check all that apply) *
All attempts will be made to accommodate your specific requests. Speaker times will be filled based on when speaker forms are filled out. Thank you again.