Speaker Interest Form

Thank you for your interest in speaking at the 2019 Net Impact Conference, which will take place October 24 - 26 in Detroit, Michigan. We'll be in touch if we find a good speaking match or need any additional information.

Personal information

First name *

Last name *

Job title *

Company or organization *

Contact name

If different from above

Contact email *

Phone number *

URL

Bio or LinkedIn profile; strongly recommended

Speaking information

Which of the following opportunities are you interested in?

Speaking

Moderating

Leading a workshop or other interactive session

Primary speaking topic area *

Secondary speaking topic area

Specific speaking topics

Keywords or phrases

What audience size are you interested in speaking to? *

Additional opportunities

Exhibiting

Exhibiting at the conference Expo

Sponsoring

Sponsoring the conference

Issues in Depth

Speaking on a Net Impact "Issues in Depth" call

Programs

Partnering with Net Impact on a special project (internship program, competition, etc.)

Speaking at a local Net Impact chapter event

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