Request for Speaking Engagement

Thank you for your interest in having Illinois EDC present or speak at your event. Please provide complete and accurate information to ensure your request is processed efficiently

EVENT BASICS

About:(Required)

Please provide a summary of the event.

Event Title(Required)

Date of Event(Required)

Event Start Time(Required)

Participant Arrival Time(Required)

Time in which participant will engage in speaking component

Event End Time(Required)

THE NITTY-GRITTY

Event Location(Required)

Street Address Address Line 2 City State

Event Host Organization(Required)

Event Contact(Required)

First Name Last Name

Contact Title(Required)

E-mail(Required)

Contact Number(Required)

On the day of the event, is there a different person to contact?(Required)

If contact name and number of individual listed above is different than the individual we should be contacting on the day of the event, select 'Yes.'

If 'yes,' what is the contact's name and preferred contact number?(Required)

Speaking Format (panel, fireside chat, keynote):(Required)

If other, what speaking role?(Required)

SPEAKING DETAILS

What topics/themes would you like covered?(Required)

Length of speaking engagement:

Will there be a Q&A or audience participation component?(Required)

Yes

Requested participant(Required)

Our organization has a robust team of experts. If your requested speaker/participant is unavailable, are you open to working with us to send another leader?(Required)

Is the event closed or opened to press?(Required)

Closed

Open

If open, please elaborate:(Required)

Link to Event Site (if applicable)

EVENT BASICS

THE NITTY-GRITTY

SPEAKING DETAILS

Have questions?