Speaker/ Conference Invitation Form

"*" indicates required fields

What is the name of your event?*

What is the date and time of your event?*

Where is the event being held?*

Who do you expect to attend?*

What do you intend the speaker to do?*

Opening address

Oral presentation

Panel member

Provide a workshop

Other

Please specify*

Please give the session start and end times.*

If known, please give the session title and details you would like covered during the session.

Please give an estimate of audience numbers*

Has a speaker fee been allocated?

Do you plan to reimburse travel costs?*

Please add any further details about the event e.g. links to programme, social media, website etc.*

Contact name*

First Last

Contact email*

Enter Email Confirm Email

Contact telephone number*

33608

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