ADMA: Nominate a Speaker

Speaker Submission Form

While speaking opportunities at ADMA events are typically by invitation only, we welcome suggestions for guest / panel speakers for some of our events. If you would like to submit a speaker nomination, please fill out and click submit. An ADMA representative will contact you if your proposal is a strong match. Please note that due to the volume of submissions that we receive, we are unable to respond personally to every submission.

REQUIREMENTS FOR SPEAKERS
(* Denotes mandatory information)

First Name*:

Last Name:

Title:

Company:

Address:

City:

State / Province:

Zip / Post Code:

Country:

Phone*:

Fax:

E-Mail*:

URL:

Nominated by: (if different from the above)

First Name:

Last Name:

Title:

Company:

Phone:

Fax:

E-Mail:

Provide a short, relevant Biography*: (80 to 120 words)

Provide one paragraph description of the proposed speaker's company*:

Presentation Experience*:

Presentation Language:

(To make a multiple selection hold down the control key on PC or the Command key on Mac)

DESCRIBE YOUR SESSION

Name of Topic*:

Topic Description*:
(80 to 120 words)

Name of Topic:

Topic Description:
(80 to 120 words)

Name of Topic:

Topic Description:
(80 to 120 words)

Preferred Speaking Chapter(s)*:

(To make a multiple selection hold down the control key on PC or the Command key on Mac)

Format / Length of Presentation*:

Equipment Required*:

(To make a multiple selection hold down the control key on PC or the Command key on Mac)

Target Audience*:

(To make a multiple selection hold down the control key on PC or the Command key on Mac)

Expertise Level*:

(To make a multiple selection hold down the control key on PC or the Command key on Mac)

Have you presented this topic before?*

Yes:

If Yes, please provide:

Name of organization / conference

Date of event

Location of event

Number of attendees

Overall session rating

Contact person

Contact phone

IMPARTIALITY:

No ADMA speaker may use a seminar session for commercial sales pitches, self- promotion or unfair criticism of a competitor. Strongly held opinions, well-founded debates and comprehensive information about products and processes advance the educational process; sales pitches do not and are unacceptable. Please disclose your interest in your subject area as a vendor, developer, evangelist or marketer.

RELEASE AGREEMENT:

Please read the following and indicate your approval by checking the box below:

I acknowledge that audio tapes, photographs, videotapes and other media including CD-ROM disks may be produced from the various lectures, speaker sessions, panel discussions, keynotes and hand out materials presented at all ADMA events, including presentations given by me and panel discussions in which I participate. I further acknowledge that such compilations of these materials may be provided free of charge by ADMA, to registered attendees of these events and other individuals.

I hereby give my permission, in perpetuity, to ADMA, their agents and representatives, to record and distribute audio tapes, photographs, videotapes and other media, including CD-ROM disks, which contain all or portion of any presentations I give, papers I present, hand out materials I distribute and panel discussions in which I participate at any ADMA event, without any obligation on their part to pay me any fee or royalty.

Having given the above permission, I retain the right to terminate said permission but must do so in writing to ADMA at least 120 days prior to any ADMA event.

I agree to the above Speaker Release.*

By submitting this form, I certify that I am the proposed speaker or an agent acting on behalf of the speaker. I have read and will comply, or will ensure the speaker complies, with the following terms and conditions.

ADMA events attract high-level executives who value the thought-leadership of presenters. The intent of each conference session is to educate and enlighten attendees, not to advertise products and services. If selected, I will refrain from including commercialism in my presentation.

If selected, I will submit my session description by the deadlines ADMA specifies. I acknowledge that ADMA may edit the session description for consistency and style.

I understand that if I am selected, I cannot send a substitute to speak in my place without ADMA's approval. If it is necessary for me to propose a substitute, I will send a written request to the conference committee at least two weeks prior to the events.

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