Speaker Request Form
Request Approved
Select an option...
Approved
Not Approved
Please indicate arrangements your organization will provide as part of AIT's participation in your event (check all that apply):
*
Event Registration
Booth Space
Air Transportation
Hotel Accommodations
Ground Transportation (i.e. taxi)
Meals and Incidentals
Speaker Honorarium
Requester Contact Information
Name
*
Name of Event
*
Name of Presentation (or what perspective would AIT add to your event? Are there topics or areas of particular interest you are interested in hearing about from AIT?)
*
Email
*
AIT Representative (Assigned by Chief Executive Officer):
Event Details
Presentation Date
*
Event Description
*
Phone (Day)
Venue Name and Address
*
Presentation Details
Presentation Time
*
Internal Notes
Phone (Mobile)
Event Date
*
Speaker Logistics
Time Zone
*
Select an option...
AST
EST
CST
MST
PST
AKST
Other
Event Type
Select an option...
Regional
National
International
Presentation Length (minutes)
*
Organization
*
AIT Use Only
# in Audience
Address
# of Attendees
Event Website
About the Organization
*
Presentation Type
*
Select an option...
Keynote
Panel
Breakout
If Panel, List Names of Other Panelists
Website
*
Event Hastag
Twitter URL for Event
Information Needed from AIT
Speaker Bio
Speaker Headshot
Facebook URL for Event
Audio Visual Provided
Projector
Screen
Laptop (Windows)
Lavalier Microphone
Upload your Agenda or Schedule of Events (if available)
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