Service Workshop Request

NETA65 Workshop Request Form

Step 1 of 2

Would you like to have someone from NETA65 be a part of your group or District’s upcoming workshop? Just fill out this handy form and we’ll be happy to assist you. If you have any questions, please send an email to [email protected]. Thank you for the opportunity to be of service!

First, let's get some basic information from you.

Your first name and last initial(Required)

First Last

Your e-mail address(Required)

Your phone number(Required)

What is your service position?

Which group / District is this workshop for?

Now, let's talk about the workshop itself

What is the TOPIC for your workshop? (It's OK if you don't know yet)

What DATE has your group/District conscience chosen? (Leave blank if you don't know yet.)

What TIME has your group/District conscience chosen? (Leave blank if you don't know yet)

How would you like people to be able to participate in this workshop (knowing the Alternate Chair can provide a Zoom ID and password if needed)?(Required)

In-Person Only

Hybrid (In-Person & Virtual)

Virtual Only

Lastly, what is the ADDRESS of the location of the workshop (if in-person or hybrid)? Please include group name if applicable.

Group Name Street Address City State Zip

Workshop Topics

Browse our Knowledge Base to view suggested workshop topics, formats and related Conference Approved Literature.

Questions? Please email our NETA65 Alt-Chair, Chris B