Please fill out this form to add a speaker.

Speaker Name:

Name of your business:

Address:

City:

State:

Zip Code:

Phone (home):

Phone (work):

FAX:

Email:

Web site:

Title of Presentation:

Type of Presentation:

I am also available to present pro bono introductions on Qigong and/or other forms of energy-work in my community:

Time of the year I am available to participate as a presenter:

Area of the country/planet where I am most available to participate as a presenter:

Main audience or interest group (select only those that apply):

All Levels

Novice Fundamentals (basics for beginners)

Some experience with qigong, tai chi or other forms of energy-work

Advanced instructions & techniques

Medical qigong/healing chi kung

Daoist philosophy and traditions

What percentage of your presentation will be lecture?:

What percentage experiental?:

Description of workshop, seminar or other presentation (up to 150 words):

Biography (up to 100 words). We need a friendly biography that includes your interest and training in Qigong:

Directions: Please be sure you have answered each category, 1 through 9, listed above.

Please be sure to include the description of your workshop or seminar and your biography.

Thank You for joining our group of national and international speakers and workshop presenters who participate in events sponsored by the Qigong, Energy-Work and Daoist community.

If you have questions about submitting a proposal:

Please contact Rebecca Kali at the Dao of Well-Being/Qigong Alliance office:

Phone: (218) 365-6330 or email: info@dao-of-well-being.com

Dao of Well-Being - Qigong Alliance

P.O. Box 750

Ely, MN 55731

Email: info@dao-of-well-being.com

Phone: (218) 365-6330

FAX: (218) 365-6933

The Qigong Alliance is a service of Dao of Well Being™ and our sponsors.

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