For Kristan’s Speaker Pages Click HereContact InformationSponsoring Organization:*Contact Name*Contact Position*Contact Phone Number*Email Address* Website URL Program / Event InformationName of Program / Event*Date of Program / Event* MM slash DD slash YYYY Location of Event*What is the Theme / Purpose of the Program / History / Event*Proposed Topic(s)*Length of Presentation*Speaking Format (panel, roundtable, keynote, etc.)*Presentation Time*Other Invited or Confirmed speakers*Audience Demographic / Details*Audience Size*Expected Media Coverage*Are travel expenses paid by Speaker or Event?* Yes No Conference Registration Provided?* Yes No Other Benefits Provided by: Trade show booth, logo in program or at event, etc.*EmailThis field is for validation purposes and should be left unchanged.
