Speaker Registration Form | Digital Marketing Topic & Trends

Speaker Information

Name *

First

Last

Email *

Company Name *

Job Title *

Phone Number *

LinkedIn Profile *

Event Details

Presentation Title *

Title should not be longer than 75 characters

Presentation Description *

Please provide more details on the topic you're planning to present.

Do you have at least 3 years of experience on your presentation topic? *

Yes
No

Please specify *

We typically require our speakers to have at least 3 years of experience on their topic. Please provide details on your experience around the topic you have chosen.

Speaker Bio *

Speaker Photo *

Click or drag a file to this area to upload.

Would you be open to participating in a panel?

Yes
No

Dates available to speak

Select 3 options below. Put the options in order of preference. We will try our best to accommodate your top choice.

Option 1 *

Option 2 *

Option 3 *

Speaker Requirements

Click the link below to review the speaker requirements
View Speaker Requirements

Do you agree to the speaker requirements? *

Yes
No