IF:Gathering | Speaker Info & Preference Form

Name*

First Last

Email*

Phone*

Assistant's Name (If Applicable)

First Last

Assistant's Email (If Applicable)

Billing Name*

First Last

Billing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Headshot*

Max. file size: 100 MB.

Bio*

Will you be bringing a guest?*

Guest Name(s)

Please list your guest(s) names. If they plan to stay with you at the hotel, please let us know so we can plan accordingly.

Dietary Restrictions and Preferences

Please list any dietary restrictions and preferences so our team can plan accordingly.

Mic Preference*

Stage Preferences

Please list any additional stage preferences (podium, water, etc.)

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