RJOS Speaker Volunteer Questionnaire

RJOS Speaker Volunteer Questionnaire

RJOS is creating a list of women in orthopaedics who would be availalbe to speak on various topics at invited lectures, courses and conferences. If you would like to be added to the RJOS Speaker List, please complete the information below.

Full Name*

First NameLast Name

Your RJOS Member Number *

Phone Number*

Area CodePhone Number

E-mail*

Institution

Specialty Within Orthopaedics

Please list three topics on which you are available to speak:

Topic #1*

Topic #2*

Topic #3*

Click the box below to certify that you give permission to be placed on the RJOS Speaker's List, and that your information may be shared for the purpose of communication with those who wish to invite you to speak. *

Yes, I give permission to be added to the RJOS Speaker's List and to allow my information to be shared.

If you should have any questions or concerns, please feel free to contact RJOS staff at rjos@aaos.org or 847-698-1626.