WCP Communications Speakers Bureau® Online Application   Use your major credit card or bank account to pay your application fee safely and securely online. After you have submitted your application click on the pay now link on the application confirmation page.
		Application Fee: $250.00 This application fee will appear on your credit card as being billed by WC Publishing.  By completing the information below, you authorize WCP Communications to bill your credit card in the amount specified. Application Fee Check here: I agree with the above terms. Speaking Platform (ex. Motivational, Youth, etc.) Desired Honorarium Area of Expertise Will you travel domestically and internationally? Do you require reimbursement for expenses? Are you a published author?  If yes, list works under credentials Full Name Company Name Area Code  Phone Number  use numbers only! Address City State/Region Alabama Alaska Alberta Arizona Arkansas British Columbia California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota Northwest Territories Nova Scotia Ohio Oklahoma Ontario Oregon Pennsylvania Prince Edward Island Province du Quebec Puerto Rico Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Outside US/Canada   Zip Code Email Address Alternate Phone Can you make references available? Referred By Please choose a payment method   Pay by check or major credit card on-line with PayPal(tm) Pay by check only via mail. This option requires extra handling time.                     Brief Description of Credentials:                       WCP Communications now accepts all major credit cards. To make your payment using this method, once you have submitted your application click on the PayPal link on the application confirmation page.
		Your Information is safe with us! Note: We respect your privacy; we will not sell or rent your email address to anyone. The information submitted on this site is used so that the WC Publishing & Printing Co., Inc. team can better service your needs. We will respond to your inquiry within 24 hours.   1959 N. Peacehaven Rd., #275 Winston-Salem, N.C. 27106 Phone: 336.794.4023 ● Fax: 336.794.4025 email us: marketing@wcpcommunications.com
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