Speaker Interest Form

Please submit this form to express interest in speaking for NCACPA.

If you have questions about this form, please contact Melissa Moon (mmoon@ncacpa.org).

Last Name*

First Name*

Primary Email*

Primary Phone Number*

Phone

Areas of Expertise*

Please enter your area(s) of expertise (Tax, A&A, etc.); one per line.

Previous Experience*

Please tell us a little about your previous experience speaking at conferences and/or developing and presenting courses. Why would you be a good fit for NCACPA?

Previous NCACPA Experience*

Have you spoken for NCACPA in the past?

Yes

Date of NCACPA Activity*

Please provide the type of event and year of your previous involvement with NCACPA.

Interested Involvement with NCACPA*

Select all that apply.

Conference Speaker

Conference Sponsor

Curriculum Speaker (scheduled Seminar, Webcast, On Demand, etc.)

Engagement or Networking Events (note that these events have a very limited, or no, honorarium)

Preferred Delivery Method*

Select all that apply.

In Person

Online

Travel*

Are you willing to travel to present at NCACPA events?

Yes

Home Base*

Please provide the city and state.

Availability*

Select all that apply.

Select

Availability Notes

Please enter any additional information about your availability.

Pricing*

Please provide a baseline estimate that we can consider for your pricing. Please note that we will ALWAYS reach out to you to discuss pricing and contract terms.

Website

Please provide your website where we can learn more about your work.

Additional Comments

What else would you like us to know about you and your work?

How did you hear about us?

File Upload

Please attach any relevant files that would allow us to consider you as a speaker for NCACPA.

Drag and drop files here or

Send me a copy of my responses

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