Guest Meeting Attendee Request Form - Ohio Speech-Language-Hearing-Association

YOUR NAME:*
First Last
Your Email:*
Meeting Date You Would Like to Attend*
MM slash DD slash YYYY
Please Indicate If There Is A Subject, Topic or Agenda Item You Are Interested In Attending For and If There Is Comment or Concern You Would Like An Opportunity to Speak To During Your Attendance
Consent*
I hearby acknowledge that as a member and/or guest of the Ohio Speech-Language-Hearing Association (OSLHA) Legislative Council (LC) meeting, I shall have access to confidential information concerning OSLHA, including but not limited to LC discussions and initiatives, contracts, legal, financial, or other proprietary information about the organization.

I agree that I will not at any time divulge any such confidential information, nor transfer any such confidential information to any third party, nor use any such confidential information for my own purpose or for any purpose other than in connection with my attendance at the meeting.

I understand that for purposes of this agreement “confidential information” shall not include information that I can establish was (i) in my possession as of this date, or (ii) was generally available to the public at the time of the disclosure.
If Approved As A Guest, I Agree to Uphold This Confidentiality Statement
Name
This field is for validation purposes and should be left unchanged.