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Presenter Submission Form

Presenter Details

First Name

*

Last Name

*

E-Mail

*

Phone

*

Job Title

*

Company / Agency

*

Experience

Highest Level of Certification

*

Highest Level of Speaking

*

Availability

Select All Time Blocks You Are Available to Speak

*

Please select every time block during which you are available. Selecting a time does not mean you will be scheduled to speak during all of those blocks — this information is used by our team to help assign your session(s) to the best possible time slot.

Select All Time Blocks You Are Available to Speak

Tuesday May 12 — Morning (8A–12P)

Tuesday May 12 — Afternoon (12P–5P)

Wednesday May 13 — Morning (8A–12P)

Wednesday May 13 — Afternoon (12P–5P)

Thursday May 14 — Morning (8A–12P)

Thursday May 14 — Afternoon (12P–5P)

Friday May 15 — Morning (8A–12P)

Friday May 15 — Afternoon (12P–5P)

Saturday May 16 — Morning (8A–12P)

Saturday May 16 — Afternoon (12P–5P)

Sunday May 17 — Morning (9A–11A)

Session Information

How Many Sessions Would You Like to Submit?

*

Session #1 Details

Session #1 — Name of Session

*

Session #1 — Description

*

Session #1 — Length

*

Session #1 — Category

*

Speaker Fees & Travel

Do You Charge to Speak?

*

Do You Charge to Speak?

A

Yes

B

No

Do You Charge to Travel?

*

Do You Charge to Travel?

A

Yes

B

No