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* 1. Your name

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* 2. Organization

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* 3. Title / Role

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* 5. Phone

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* 6. What session are you interested in facilitating (if more than one, please submit a separate request for each):

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* 7. Provide a brief description of your organization (if applicable)

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* 8. Proposed session title

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* 9. Session description (approx. 150-200 words)

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* 10. What are the 3–4 key takeaways participants will leave with?

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* 11. How will you engage the interns / what format will you use? (select all that apply)

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* 12. Have you facilitated similar programs before?

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* 13. If yes: please list one or two examples (name of program, audience size, date)

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* 14. Please provide relevant credentials or background (Optional: Include links to past talks, videos, references)

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* 15. Do you require any special equipment or setup? (E.g., projectors, breakout rooms, whiteboards, flip charts)

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* 16. Is there any additional information we should know?

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* 17. Is your organization willing to host, and do you have the appropriate space and resources to host up to 75 interns?

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* 18. By submitting this form I commit to volunteering my time for this session and understand this is not a paid engagement.

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