SQA Distinguished Speaker Request Form

The Society of Quality Assurance Learning Foundation (SQA-LF) has established a Distinguished Speaker program that identifies and recognizes the top-rated SQA speakers each year. Individuals who are invited to join the Distinguished Speaker Inventory are experts on a wide variety of Quality Assurance (QA) topics, and they have demonstrated their skill in presenting to audiences in a meaningful and engaging way. A current list of Distinguished Speakers is available at http://www.sqa.org/speakers.

SQA Chapters, other QA organizations, and other scientific nonprofits and associations are invited to request that SQA and the SQA-LF provide a speaker from the Distinguished Speaker Inventory to speak on a desired QA topic that is within the scope and mission of SQA and the SQA-LF. The Requesting Organization must complete the application below and agree to the terms at the end of the application. SQA cannot guarantee that a speaker will be available on the topic, date, or under the terms required by the Requesting Organization, but a good faith effort will be made to accommodate as many requests as possible.

Requesting Organization Name

Contact Person for the Requesting Organization

First NameLast Name

Contact Person's Email Address

example@example.com

Presentation Title or Topic for which You Are Requesting a Speaker

Be as specific as possible; the more specific you are, the better we can match your needs with the right speaker.

Proposed Date for the Presentation (if known)

Date

Proposed Time for the Presentation (if known)

:HourMinutesAM/PM Option

What is the format of the presentation you are seeking?

Other

How long will the speaker be expected to present?

In minutes or hours; please specify which unit of measurement you are indicating.

Where will the presentation take place?

City, State/Province, Country

If we cannot find a speaker who is an expert on the topic you have requested who can travel to the location specified, would you be interested in organizing a remote/web-based presentation by a qualified speaker?

Is your organization prepared to pay for a speaker's travel expenses and/or a speaker's fee in exchange for their presentation? (If you say No, we will still try to match you with a speaker who may be local to you or traveling to your event anyway, but it will be much easier to find a willing speaker if the answer to this question is Yes.)

Please provide us with the details of the financial support and/or compensation your organization is prepared to provide to a speaker.

Specific details can be worked out with the speaker at a later time, but it is helpful for you to indicate something like, "We can provide domestic economy-class airfare and 2 nights of hotel, but we cannot cover any meal/per diem expenses" or "We can offer $1500 toward travel, hotel, and meals and a complimentary conference registration" - something we can share with the speakers up front to help them decide whether or not they'll be able to present.

Please provide any other details you think SQA and/or the prospective Speaker should know about this organization or this presentation opportunity.

Please indicate your acceptance of ALL of the following terms and conditions by clicking the box next to each item.