Innovate Alabama Speaker Request Form
Are you interested in having a representative of Innovate Alabama speak at your event? Please submit this form for your request to be considered.
If your event is more than one day, please give the date and time you would like an Innovate Alabama representative to speak.
Please be as precise as possible with the anticipated time commitment. (e.g. 0:45 for 45 minutes)
Sponsoring Organization(s) & Event Name *
e.g. EDAA Winter Conference, Dothan Networking Alliance Weekly Meeting
- {name}
Primary Event Contact Name *
- {name}
Relevant Background Information *
Provide any essential history or context about the sponsoring organization(s) and/or the event.
- {name}
Purpose *
Describe the purpose and why Innovate Alabama's presence would add value to this event.
- {name}
Please indicate if your event is virtual.
How many attendees are expected?
Audience Description *
Who is the main audience for this event? Be as specific as possible. (e.g., early-stage tech entrepreneurs, HBCU students in STEM, state and local policymakers, investors, community leaders, etc.)
- {name}
Role Description *
Please describe how you would like Innovate Alabama to participate. (e.g., keynote, panel speaker, fireside chat, etc.)
- {name}
If you have a particular Innovate Alabama speaker in mind, please list their name. Innovate Alabama reserves the right to send an alternate.
Topic & Preparation *
Are there specific topics or questions that you would like the speaker to address during their presentation? If yes, please provide details to help guide the speaker's preparation.
- {name}
Q&A *
Would you like the speaker to participate in a Q&A session after the talk?
If yes, list any specific questions or topics for Q&A:
- {name}
Are media invited or confirmed to attend? *
Select an option
Is a press release planned for this event? *
Collateral Material(s)
Please share any additional information and/or promotional graphics.
Attach file
Drop files here
STATUS
- Idea
- Pending
- Confirmed
- Complete
- Materials Needed
SOURCE
Additional Notes
Is there anything else you would like us to know?
- {name}
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