Chapter Speakers Bureau - Broward County DSA

Broward County DSA

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Full Name

Pronouns Pronouns

Phone Number

Zip Code

Email

Did you mean?

Student

Student

No Yes, college student Yes, graduate student Yes, high school student

Union Member

Union Member

Unknown No, not a union member Yes, retired union member No, but former union member Yes, current union member Currently organizing my workplace

Are you an official DSA member in good standing?

Are you an official DSA member in good standing?

Yes Unsure No / New to DSA

Areas of Expertise Areas of Expertise

Select all that apply.

If "Other" list topics here:

Briefly describe your experience with these topics

(lived experience, organizing, professional background, etc.)

What formats are you comfortable with? What formats are you comfortable with?

Check all that apply

Please list any languages you are comfortable speaking in:

Are you comfortable being listed publicly as a speaker, or should your info remain internal only?

Are you comfortable being listed publicly as a speaker, or should your info remain internal only?

Public is okay! Internal only

Do you have any accessibility needs we should be aware of?

Optional (e.g. mobility, audio, breaks, virtual preference)

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