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Oregon Environmental

Health Association

AEC Speaker Application

First name*

Last name*

Pronouns (optional)

Email*

Website (optional)

Employer (optional)

Position (optional)

Credentials (optional)

Speaker bio (less than 200 words) *

Title of Talk*

Duration of talk (including time for questions) *

Short description of talk (less than 200 words) *

Preferred track: (select all that apply): *

General

Food/Pool/Lodging

Onsite Wastewater

Time constraints and preferences (optional)

Photo (optional; please upload a photo of yourself that we can include on our website)

Dry Leaf

The Oregon Environmental Health Association (OEHA) is a registered 501(c)6 tax exempt organization and is an affiliate of the National Environmental Health Assocation (NEHA).

GuideStar Non-Profit 2023 Silver Seal of Transparency

CyberGrants FrontDoor verified.

EIN #: 23-7051708.

Mailing address: P.O. Box 3724, Hillsboro, OR 97123.

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