Request a speaker

Brand USA welcomes the opportunity to speak at industry events. To help us better determine availability and identify the most appropriate executive to speak at your event, please complete this form

Request Speakers

Event Requester Contact

First Name

Last Name

Title

Organization

Primary Phone

About the Organization

The organization hosting the event.

Name of Organization

Organization Website

About the Event

Name of Event

Start Date

End Date

Venue Name

Event Venue Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Expected Size of Audience

Key Sponsors of the Event

Link to Conference / Event Website

Presentation Details

Name of Presentation or Session

Description and/or focus of presentation

Date of Presentation

Start Time

End Time

Speaker Details

Dropdown

Will Media be Present?

Yes

Type of media and/or publication name

Deadline to Confirm Speaker

Please list any other requests you have of the Brand USA executive attending your event such as any other events you would like him/her to participate in while at the event. If there is not a request for the speaker to attend any other events, please state "N/A".