Speaker Application

* Name

* Credentials/Title

Company

* Street Address

* City/State/Zip Code

* Phone Number

* Email

* Title of Presentation

* Date of Presentation

* Time of Presentation

* Speaker Stipend

Presentation Format

Additional Audio/Visual Equipment Requirements for Live presentation (basics available to Speaker: Laptop, LCD projector, laser pointer, screen, microphone)

* Brief Program Description

* Learning Objective #1

* Learning Objective #2

* Learning Objective #3

IAMSS Speaker Guidelines:

1. Stipend: IAMSS will reimburse Speaker within 2 weeks after receipt of invoice and W9 emailed to [email protected].
2. Travel: IAMSS will reimburse Speaker for standard airfare, standard car rental (no upgrades) from itemized statement emailed to [email protected].
3. Hotel: Speaker makes own hotel reservations; IAMSS will reimburse for hotel room only (no amenities) from itemized statement emailed to [email protected]g.
4. Conference Registration: Speaker must register on own; there will be no charge to attend (choose to "pay by check").
5. Speaker agrees to email Presentation, photo, and short introductory bio at least 30 days prior to program to [email protected].
6. Speaker agrees to participate in at least one planning conference call with IAMSS to be scheduled in advance of the program at a pre-determined date and time convenient to all.
7. Speaker agrees to be recorded for presentation to be shared with virtual conference attendees only.

Electronic Signature of Speaker By typing your name, you are confirming that this serves as your electronic signature, and you agree to the IAMSS Speaker Guidelines.

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