IOAD 2026 Speaker Application
Thank you for your interest in speaking at the International Overdose Awareness Day event on August 31, 2026 at Sarg Hubbard Park. Please fill out this application to be considered. The Selection Committee will be in touch with more information if you are selected as a speaker.
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
How has overdose affected your life?
*
I am a survivor of overdose
I am a family member/loved one of someone who experienced an overdose
I am a health care professional
Please share your story
*
Do you want to add a loved one to the memorial wall? (Please fill out the next section)
*
Yes
No
Back
Next
Forget Me Not
Please fill out this section if you would like to add a loved one to the memorial wall.
Their name:
When did they pass away?
-
Month
-
Day
Year
Date
Age when passed away
Please share their story:
Please upload a photo of your loved one
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Submit
Should be Empty: