Presenter Submission Form

What program or event are you presenting at?(Required)

IMPORTANT: Please select the program or event you are speaking at from the dropdown menu.

Name(Required)

Please provide your name as you would like it included on promotional materials.

First Last

Email(Required)

Organization/Enterprise

Your role or title

Please include your role (CEO, founder, etc)

Website

Upload Your Headshot & Logo(Required)

Please upload high resolution copies of your headshot and logo(s). If you have a black and white or transparent background version please include this as well.

Drop files here or

Max. file size: 128 MB, Max. files: 5.

Please provide a short, one paragraph description of your organization (250 words max).

Please provide your bio (250 words max).

Additional Links/Social Media

Please share any additional links or social media such as LinkedIn and Instagram to include in our marketing and materials.

Additional Links/Social Media

Please share any additional links or social media to include in our marketing and materials.

Additional Links/Social Media

Please share any additional links or social media to include in our marketing and materials.

Co-Presenters (if applicable)

Please include the names of co-presenters if applicable.

Are you presenting a workshop?

If you are presenting a session or workshop please provide workshop or session description (250 words max)

Workshop or Session Title

If you are presenting a session or workshop please provide workshop or session title.

Workshop Requirements

Please let us know the room set up and any material AV requirements you have for your workshop.

Media Consent(Required)

By submitting this form I consent to being included as a presenter in Hollyhock event promotion, social media and website.

Yes

Content Capture & Distribution

As part of our mission to share resources in support of advancing movements, would you be comfortable with your session being recorded and distributed following the event?

No thank you

Yes, but please only share with attendees from the program.

Yes, my content can be shared in any context. I understand that I will be credited for my work, including links to my website or social media.

Let’s discuss

Other

Comments

This field is for validation purposes and should be left unchanged.

Presenter Submission Form

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