Request a Speaker

Name of Requesting Group*

Audience Type

Choose all that apply

Other Audience Type/Association Membership Description

Group Contact Name*

First Last

Group Contact Title/Role*

Group Contact Phone*

Group Contact E-mail*

Presentation Venue*

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 at https://www.mcit.org/speaker-services/

Expected Number of Presentation Attendees

MCIT requires a minimum of 20 attendees.

Which of These Presentation Materials Can You Provide?

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

CAPTCHA

Request a Speaker/Training Session