Speaker Submission Form

  • Name as you want it to appear on this Website and in the Program Guide. Please include ", Ph.D." at the end of your name, if applicable.
    Please select all that apply to you.
  • That you can be reached by prior to and while at the event.
  • The one you want on the website and in the Program Guide.
  • As you want it to appear on this Website and in the Program Guide.
  • As you want it to appear on this Website and in the Program Guide.
  • (i.e. Education, Research, Legal, Marketing, etc.)
  • Personal if not business. This will be hyperlinked in your Speaker Profile on this Website.
  • Please make sure your Linked In is updated!
  • This will appear in your Speaker Profile on this Website.
  • This will greatly increase your chances of passing our vetting process.
  • This will be in the Biography of your Speaker Profile on this Website. Please add details of your presentation topic. Presentation abstracts will be collected in July and slideshows will be collected in August.