Columbus Rotary Program Committee's Vision: Inspiring Rotarians to new levels of insight and service.

Mission: To recommend and acquire weekly luncheon programs which inform members by providing insight and useful information on topics of significance in the conduct of business and citizenship.

Speaker Name & Organization:

Submitted By:

Submitter’s E-mail:

Submission Date:

Topic:

Brief Summary (500 words or less) of why this speaker should present before our group and any information which would be helpful to our committee for the evaluation of this speaker:

Have you heard this speaker present before?

Yes No

How would you rate the message that this speaker has to deliver? (1 low - 10 high):

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How would you rate this speaker's ability to present the message? (1 low - 10 high):

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Do you have a personal relationship or familiarity with this speaker?

Yes No

Do you have additional information to submit for this speaker? (link to website, copy of previous presentation, etc.):

Rotary Action Taken & Dates:

Enter the numbers and letters exactly as you see it on picture above:

Thank you!