Apply to speak at a PSA regional event

Name*

First Last

Email*

Telephone*

Membership level*

Which region(s) would you like to speak at?*

What kind of talk is this?*

Title of your talk*

Summary of your talk*

What kind of audience are you aiming at?*

What are the key takeaways for your audience?*

Your bio*

This is a short description of you as a speaker that may be used in our event marketing.

Your introduction*

This is a short introduction that the MC will use to introduce you at the event.

What kind of feedback are you looking for?*

Code of Ethics*

You are required to agree to the PSA Code of Ethics.

When I submit this form, I understand that the PSA will process my information in accordance with its Privacy Notice.