Speaker Request Form

Would you like Eric Angel to speak at your upcoming event? Please complete this form and a member of our team will follow up with you directly.

Event date

Event start and end times (please specify time zone)

Event name

Is this a virtual or in-person event?

Virtual In-Person

If an in-person event, list the event location with address

Nature of request (ex. meeting presentation, keynote speaker, panelist, moderator, etc.)

Requested arrival time

Name of host institution/organization/company

Requested length of speech or presentation

Please provide a detailed description of the requested subject matter. List any key points or issues you would like Eric Angel to address:

Please list additional event speakers or panelists on the program, if any:

Target audience for this event (e.g. expected number in attendance, audience affiliations, and/or audience demographics)

Will press be present at the event?

Recommended attire

Your name

Your email address

Your phone number

Name of contact for event logistics

Logistics contact email address

Logistics contact phone number