Become an ECMC Speaker!

Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Check Appropriate Audience *

Who is your audience? Check all that apply.

Infants

Toddlers

Twos

Threes

PreK/Kinder

Directors and Admin

Experience Level *

My topic is appropriate for

Beginner

Experienced

Both

Core Knowledge Area for Worksop *

Check all that apply.

Child Growth and Development

Health, Safe Learning Environment

Professionalism

Culture & Individual Diversity

Family & Community Relationships

Guidance

Professional Practice, Methods & Curriculum

Observation & Assessments

Preferred Seating *

Lecture

Perimeter Seating

Would you like a music stand or a podium? *

Yes

No

Do you need an easel? *

Yes

No

How many display tables do you need? *

None

1

2

3

4

Media Support *

You must be able to provide your own computer. Our Rooms are presentation ready. We are unable to provide Thunderbolt and USB-C adaptors for Apple computers. Please provide your own HDMI adaptors.

I will require media support

I will NOT require media support

Presenters, please complete the following information: *

I am a registered trainer with the Texas Registry.

If you are not in the Texas Trainer Registry, how do you meet the TDFPS licensing qualifications to provide training?