Request a Speaker

Name of Requesting Group*

Audience Type

Choose all that apply

General staff
Department heads, managers, supervisors
Association members (describe below)
Other (describe below)

Other Audience Type/Association Membership Description

Group Contact Name*

First Last

Group Contact Title/Role*

Group Contact Phone*

Group Contact E-mail*

Presentation Format Preference

Some sessions can only be presented in person. Check session descriptions to see whether the topics you want can be presented in your preferred format.

In-person (minimum audience of 20 people)
Virtual (minimum audience of 10 people)
No preference

Presentation Venue for In-person Sessions

General location of the presentation, e.g., county courthouse, hotel, convention center, etc.

Presentation Venue Address

Street Address Address Line 2 City State ZIP / Postal Code

Preferred Presentation Date

Alternate Date #1

Alternate Date #2

Presentation Topics Requested*

Presentation topics and descriptions are posted on the Speaker Services page.

Expected Number of Presentation Attendees

MCIT requires a minimum of 20 attendees for in-person presentations and a minimum of 10 attendees for virtual sessions.

Which of These Presentation Materials Can You Provide? (In-person sessions only)

Computer or laptop
Projector
Screen or white wall
Large monitor or smart board
Microphone
Internet connection/WiFi

List Any Specific Issues or Concerns You Would Like Addressed in the Presentation

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