DRC Speaker Information Collection

Presentation Title *

Summary *

600 character limit. Please include a three sentence workshop description which will be used to promote your workshop on the registration website and in the conference brochure.

Learning Objectives

Please briefly describe the goals of the presentation.

Primary Presenter's Name *

First

Last

Primary Presenter's Job Title *

Primary Presenter's Organization *

Primary Presenter's Email *

Primary Presenter's Phone Number *

Primary Presenter's Website

Primary Presenter's Biography *

Please include a 7-10 sentence paragraph to be used for presenter introduction at the conference.

Primary Presenter's Headshot - Please Attach

Click or drag files to this area to upload. You can upload up to 3 files.

Your headshot may be used for conference marketing materials such as website, brochure, etc.

This form will not save a draft. Consequently, you will lose all information entered unless you hit "Submit". We recommend gathering all info required prior to completing this form.

You will receive a confirmation email after you submit the form. If you do not receive a confirmation email, the form was not successfully submitted.