Public Safety Resiliency Summit-2022
SPEAKER INTEREST FORM Please fill out this form fully to indicate your contact information and the logistics for the presentation you would like to present. If your presentation is selected by our training board you will be contacted and further scheduling arrangements will, be made.
Presenters Name
First Name
Middle Name
Last Name
Level of Education or Experience (Detective, Psychologist, Commander, etc.)
Organization, Department, or Agency
Email
example@example.com
Contact Phone Number
Presentation Title
Short Presentation Abstract/Summary (less than 500 words)
Preferred Presentation Length
1 Hour
2 Hours
4 Hours
Flexible
Required Fee if Any
Mailing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name(s) and Credentials of any Co-Presenters
Additional Comments
LOGO or Other Document Upload
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