2020 FSDS Speaker Volunteer Form

October 23 - 25, 2020 at The Breakers, Palm Beach, FL

If interested in speaking, please complete the information below. The program committee will review your submission and contact you about placement in the program.

Forms must be submitted by Wednesday, February 5, 2020 to be considered.

Question Title

* 1. Contact Information

Name *

Company *

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address *

Phone Number *

Question Title

* 2. Are you a Member in good standing of the FSDS?

Question Title

* 3. Session Topic 1

Title of Talk

Educational Objective 1

Educational Objective 2

Question Title

* 4. Session Topic 2

Title of Talk

Educational Objective 1

Educational Objective 2

If selected to speak at the 2020 Annual Meeting, please note that the below requirements must be met in order to remain on the program Faculty.

Deadline dates will be communicated upon speaker selection and are required to be met in order for us to provide an outstanding program to attendees.

Session details (including title and educational objectives)
Completed Disclosure Form
- Presentation may be required if there are Disclosures, this will be due months prior to the meeting
Commitment to date/time of talk
- Schedule conflicts must be communicated in advance of planning