Speaker Request Form

Thank you for reaching out to request a speaker. Please answer the following questions so that we can respond to your request in a timely manner - we request at least 60 days notice for a speaker or panelist and at least 30 days notice for requesting our attendance.

1. Please provide the title, purpose, short description of the event, and event url (if available).

2. What is the date, time, and location? If virtual, please specify the platform, if known.

3. Which of the following are you seeking? Check all that apply.

Speaker

Panelist

Attendee

Other

4. How many attendees are expected?

5. Please provide more information on the topic(s) and format of the speaker or panel presentation you're seeking (e.g. amount of time, names of other panelists, etc).

6. Is there a cost to attend? If so, how much?

7. What is your deadline for responses?

8. Please provide event organizer's name and contact information.

9. Please share any additional information that would be useful for us to know (e.g. whether the presentation will be recorded & how it will be shared, audience composition and level of knowledge about ACEs, amount of time for speaker, whether there will be Q&A)

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