Online Panel Guest Confirmation Form

Hello, thank you for your interest in being a guest speaker at our monthly mixer. We typically schedule our guests three months in advance based on availability. Please enter your profile here to be added to our database to be considered for 2024. *Please note that filling out this form does not guarantee your selection as a speaker, as many factors are involved in our preparation. If selected, our team will reach out to you by the contact you provided ahead of time for preparation to confirm your availability. Due to the number of submissions we receive, we may be unable to reach out individually to every application. We appreciate your understanding in advance. Please note that we have no payment for speakers, but if selected, we may reimburse gas mileage for locals.

Name

Please confirm your email

Which activity would you like to be considered for?

Profile

Please add in your relevant experiences for the activities you selected and your professional qualifications.

{name}

Portfolio Link

Social Media you would like to share

Please include any insta/ fb/social media handles, special upcoming promotional events or portfolio link you would like to share and specify platform

{name}

By checking this box, you acknowledge that you understand and agree for us to use the media you provide in this form as well as your recorded presence for ASIFA-South's public promotional purposes.

If you would be interested in any of the following, please check.

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