Guest Speaker Request Form

* 1. What is your Name?   
Please include Rank, Title, Etc.

* 2. What Organization do you represent?

* 3. What is your Email Address?

* 4. What is the title of the session that you would like to provide? 
If you have multiple session topics, please submit a separate entry for each one 

* 5. Which of our 3 Tracks would your session be most appropriately placed?  

* 6. If necessary, could your session be modified to fill a slot in any of the other tracks?  Please select all tracks that would be a possibility 

* 7. Our events typically have time slots of various duration. What would be the most appropriate time slot needed to adequately cover your session material?

* 8. Please provide a brief session description, of approximately 150 words.

* 9. Please provide a brief bio of yourself, also of approximately 150 words. 

* 10. Please note... with extremely rare exception, FACA is unable to pay speaker fees and/or make reimbursements for travel expenses. However, FACA will typically offer our guest speakers a complimentary "Full Conference Registration", which includes all conference related meals, as well as admission to the Awards Banquet and after party. Please advise what minimum requirements you would have to participate in our event?