Transgender at Work is assembling
a list of transgender speakers and workshop presenters around the
United States.  This list will be used as a resource by corporations
desiring to educate their employees, universities educating their
students and faculty, community groups, and others.  This list will
be published on the Internet and made available to organizations
interested in transgender education.

You have been recommended as a possible presenter for this list.
There is no charge for this listing.  Do you want to be listed?
If not, please let me know and I will delete you.  If yes, please
fill out this survey and return it to me.  If you know of others
who should be listed, please feel free to send this survey to them.

Please return completed surveys to
	Mary Ann Horton
	mah@tgender.net	(e-mail is strongly preferred)
or at
	It's Time, Ohio!
	PO Box 21310
	Columbus, OH 43221
or FAX:	(614) 235-9967.

		QUESTIONS FOR TRANSGENDER PRESENTERS

Please supply contact information about yourself.  This will be made
public on the Internet.  List all that apply.

  Name:

  Organization:

  Postal Address:

  City, State, Zip:

  Telephone:

  FAX:

  E-Mail Address:

  Web address:

QUALIFICATIONS

  What degrees/credentials do you hold?

  How do you earn your living?

  How many years in serving TG field?

  What is your relationship to the transgender community?  For example,
  Are you transgendered, or is a spouse or family member, or do you
  work in some professional capacity with the transgender community?
  Please specify.

  How many times have you given TG workshops, to date?

  How many times have you given other workshops, to date?  On what topics?

  Please estimate the percentage of your workshops for which you
  receive a speaking fee.

  Please specify any additional qualifications that may help match you
  to speaking requests, such as fluently speaking languages other
  than English, religious affiliations or clergy status, race, sexual
  orientation, etc?  (For example, we may get a request for a transgendered
  bisexual.)

  Do you care to list any references who have attended your presentation?

  Comments received from those attending your workshops?

PRESENTATION INFORMATION

  What type(s) of session do you normally present?

	  Experienced keynote/plenary speaker.
	  Individual speech.
	  Panel Workshop.
		  (specify typical composition of panel)
	  Individual Workshop.

  Please describe the sort of presentation you give?

  What is the usual time length of your session?

  Who is your typical target audience?

  To what extent do you emphasize:
  (please use a 0-5 scale, 0 is "not at all", 5 is "major focus".)
	___ Transsexuals
	___ Crossdressers
	___ Intersex
	___ Male to Female
	___ Female to Male
	___ General education ("TG-101")
	___ Workplace issues
	___ Family issues
	___ Partner issues
	___ Youth issues
	___ Spiritual issues
	___ Minority issues (other than GLBT)
	___ Legal issues
	___ Psychotherapy
	___ Theoretical issues
	___ "How to" for TGs
	___ Medical issues
	___ Advocacy/Political issues
	___ Social issues
	___ Gay/Lesbian/Bisexual issues
	___ Straight/Hetersexual/non-transgender
	___ Humor as part of the presentation
	___ Emotional appeal

  Do you charge for your presentation?  How much?

  Can you travel?
	  Nationwide
	  Regional (specify)
	  Local only (specify area)

  Please characterize yourself as a speaker about transgender issues:
  (choose the one that matches most closely.)
	___ Have not presented, but I would be willing to speak if asked.
	___ I have appeared as a panelist.
	___ I have given a free speech
	___ I have given a workshop or speech for a fee
	___ I have given many presentations, at least three for a fee
	___ Giving presentations is a major part of my life.
	___ I make my living giving presentations.

  Do you offer any other services to the transgender community you
  would like to have listed here?