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Chapter Speaker Request Form for IAEE Leadership/Staff

When requesting an IAEE staff or board member for speaking engagements, the following information will be sent to Lisa Buchanan.

    * Required Fields

    Chapter Name:*

    Contact person:*

    Contact email:*

    Contact phone:

    On-site contact person:

    On-site contact's mobile phone:

    Date of Event:

    Time of Event:

    Choose from the following speakers:

    IAEE Chairperson
    IAEE Chairperson-Elect
    David DuBois, CMP, CAE, FASAE, CTA, IAEE President
    Cathy Breden, CMP, CAE, CEM IAEE Executive Vice President & COO/CEO, CEIR
    Other IAEE Board Member
    Other IAEE Staff Member

    If you chose "Other IAEE Board Member" or Other IAEE Staff Member", please include their name below:

    Desired Topic:*

    Type of event (breakfast, luncheon or networking event)*

    Location of program (include address or virtual):

    Expected attendance: *

    Will chapter make hotel and ground transportation arrangements?