OSA Traveling Lecturer Program Participation Form

Please complete all fields.

Please indicate the OCIS codes that best fit your areas of expertise. If you wish to speak about non-technical topics (e.g. careers, public speaking skills) you are encouraged to add those as well. You may choose as many codes and topics as you like; please list all OCIS codes, their corresponding descriptions, and any additional discussion topics.

Please enter a short biography (a Word or PDF file may be sent to chaptersandsections@osa.org if preferred):

Please provide a photo to accompany your bio (optional): (Only Doc, Docx, Pdf, Jpg, Gif and Png files are accepted)