Speakers List Application

Thank you for your interest in being added to the OA Region3’s Speakers List.  Being a Speaker is critical to our recovery.  Please register and let us know a little bit about yourself.

Please Read and Confirm the following before completing the details of the form.

I certify that: *

Two references will be required to complete this application.  Please have that information ready before beginning.

(XXX) XXX-XXXX
Are you maintaining a healthy body weight?
Subject(s) about which you would like to speak
Are you willing to speak virtually?

References

Please list two references with an email or cell phone number whom we may contact about your experience, strength and hope message.  As well, please contact your reference to get their permission to share their information and so that they know to expect a Region 3 call.

First

First and Last Name
Reference Email address or cell phone number

Second

First and Last Name
Reference Email address or cell phone number

Once application is successfully submitted, you will be redirected to a confirmation page.