Speakers Bureau Form

Requester Information
(what are you looking for and who are you)

First name (required)

Last name (required)

Organization (required)

Email (required)

Telephone (required)

Speakers Bureau Information

What topic(s) are you wishing to discuss at your event?

Event type: (conference, panel, workshop)

Proposed event date (required)

Event duration (required)
---MorningAfternoonEveningMulti-dayFull-day1-2 hours

Language preference (required)
---EnglishFrench

Approx. number of attendees

Audience type (employees, public, HR professionals)

Additional details

How did you hear about the Speakers Bureau?