Speakers Bureau Application

Speakers Bureau Application
The ASA Speakers Bureau is a repository of qualified ASA members who are available to speak about a variety of statistical topics and career paths.

For in-person events, the ASA will reimburse travel and technology set-up costs up to $500 to help facilitate the event. For reimbursement approval, the event host must evaluate the speaker and the speaker must provide receipts for any expenses incurred. Expenses must adhere to ASA travel reimbursement guidelines. Also, all speakers must affirm they will abide by the ASA Code of Conduct.
Name*

First NameLast Name
Email*
example@example.com
Job Title*
Home City*
Indicate the general topics you would be willing to present. If you check other please describe. [Check all that apply.]*

Career OpportunitiesUndergraduate or Graduate Programs of StudyProfessional Skills DevelopmentStatistical MethodsOther

Indicate audiences to which you would be willing to present. [Check all that apply.]*

Student Chapter (Undergraduate or Graduate)K - 12 StudentsK - 12 TeachersGeneral PublicMediaOther
Are you willing to travel for in-person presentations?*

YesNoMaybe
Please use this space to provide additional information.
Should be Empty: