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Speaker Request Form

 

Event Data/General:

Requester Name:

Name of Event:

Date:

Location:

Phone:

Email:

Audience background:
Developer 
IS 
Management

Technical Level of Audience:
High  
Medium 
Low

Knowledge Level of OT :
High  
Medium 
Low

Presentation Topic:

Key Issues to be addressed:


Format of Session:
Formal 
Roundtable
Other

Amount of Time Allocated:

Travel Expenses, will you as the host cover expenses?
Yes
No

Location Specifics For Corporate Events:

Company:

Division:

Address:

Primary Industry:

Current OMG member?
Yes
No

Date Requested:

Alternatives Dates:

For Tradeshow/Conference:

Event Name:

Primary Event Focus:

Date of Session:

Time of Session:

Location:

Please, type (or highlight and drag-and-drop) this code 3TMw8 into the field below, to complete the registration.

 

 

 
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