Speaker Submission form.We look forward to featuring you at a District216 Marquee Event, or evening at The District House! Name * First Name Last Name Email * Phone (###) ### #### Title / What you do? Where are you located? Speaker Type TDH - Speaker Interview / Presentation TDH - Interactive Workshop TDH - Brand / Product Activation Marquee Event - Discussion Panel Marquee Event - Fireside Chat Speaker Topic Title for Presentation, Panel, Workshop or Demo Description of Topic Description for Presentation, Panel, Workshop, or Demo Company Name Date of District216 Event MM DD YYYY Website to Feature http:// Instagram URL http:// Facebook URL http:// LinkedIn URL http:// Headshot Link to a photo we can use of your beautiful face. Photo(s) to Feature (3-5 ideally) i.e. Dropbox link, Google Drink link, etc. Speaker Biography Speaker Pledge * If I am selected as a District216 speaker, I will meet all pre-determined deadlines set by the team, and I will not change the content of my presentation without documented consent from District216. I understand that I am responsible for my own costs associated with my presentation. I grant District216 permission to record audio/visual of my presentation and distribute or share it in any medium for any purpose. I will follow all venue regulations, and I will not display/bring psychedelic plants or substances into the venue. I understand and agree that speaking sessions must be purely educational and may not be sales pitches or company-specific promotions. I agree to abide by all the requirements contained within this speaker pledge. If I am filling this application out on behalf of someone else who will be speaking, I confirm that I have been authorized to complete this application on their behalf and that they have confirmed to abide by and be bound to this speaker pledge. I Agree to the Speaker Pledge Thank you! We look forward to having you at District216.
