Speak At An Event

We appreciate your interest in speaking at one of our upcoming events. We host a wide variety of events from conferences with exhibit halls, online webinars, lunch and learns, after hours events, and much more.

How To Apply To Speak At An Event

To get started, just complete the form below. This will provide us with the details that we need to understand your topic, at what event you want to present, and how we can get a hold of you to discuss our opportunities further.

Guest Speaker Request Form

Guest Speaker Contact Information

Please provide your contact information below.

First Name

Last Name

Your Credentials

Certification(s)/Agency

Area of Expertise

List Your Relevant Experience Pertaining To the Topic To Be Presented (papers, presentations, publications, etc.)

Company Name

Your Role or Position

Company Address

Address Line 1

Address Line 2

City

State

Zip Code

Company Logo

Choose File

Your Best Phone Number

Your Best Email Address

Session Information

For your session or presentation, we need some additional information from you.

Presentation Type

Presentation Title

Description of Session (limit to 50 words and be as specific as possible about the learning to take place)

Level of Instruction

Basic: Entry level, no prior knowledge of subject necessary to attend this program

Intermediate: Refresher course, some basic knowledge required

Advanced: Highly technical, for those with at least five (5) years of experience in a specialty

Program Objectives (please list three)

Audiovisual Needs (if applicable)

Preferred Date of Session

Session Presentation or Slides and Other Handouts

Choose File

Speaker Information

Please provide the following details about you, the speaker. This will be used for programs, marketing, etc.

Speaker Bio

Speaker Curriculum Vitae (CV) or Resume

Choose File

Speaker Photo (High Resolution)

Choose File

I agree to sign and return a speaker/presentation consent and releasse form to ASCLS-MO prior to me presenting.

Yes

I agree to provide the program committee with handouts for the presentation at least five (5) business days prior to the presentation, unless other arrangements have been made.

Yes

Other Arrangements Have Been Made