SPEAKER BOOKING FORM
Artists Talks are 3-4PM on Sundays at the Wildling. Please fill out this form as completely as possible. This information will be used to propagate invitations, our visiting speakers' web pages, news releases, and other material used to promote our speakers.
Full Name:
*
Prefix
First Name
Last Name
Photo (500 or more pixels wide)
Upload a File
Cancel
of
Bio:
*
Links to other speaker-related info:
Links to publications, etc:
Title of talk:
*
Description of talk:
*
The speaker consents to photos being taken?
*
Please Select
Yes
No
The speaker consents to the event being recorded?
*
Please Select
Yes
No
The speaker consents to live streaming or interaction via Skype?
*
Please Select
Yes
No
Other notes:
Submit
Should be Empty: