Speaker Form

Interested in Becoming a Speaker?

Interested in becoming a speaker or facilitating an event at the 2024 Western Pennsylvania 2024 Regional Gathering? Fill out and submit the form below. Have questions? Just ask! We’d love to hear from you.

2024 RG Speaker Form

Thank you for agreeing to speak or facilitate an event at the Western Pennsylvania 2024 Regional Gathering. We want to ensure that your event is easy, fulfilling, and fun! We need some information so we can set you up for success!

First Name

Last Name

Phone

Email address

Name of Your Presentation/Event

Description of your presentation/event

Your bio (for the RG program)

Do you need any equipment or specific room layout for your presentation/event?

Length of presentation/activity:

Most presentations and other activities are scheduled for 50 minutes so that each can start on the hour, with ten minutes between to set up and break down. Please indicate how much time you would like for your presentation/activity.

Assistance:

If you would like a volunteer to show you around, help you set up and clean up, introduce you, or help you in any other way, please provide a brief description of the type of assistance you would like.

Success:

Is there anything else we can do to set you up for success?