Spring Conference Profile Form | NHBSR

"*" indicates required fields

Please fill out this Conference Speaker form, if you have any questions, please feel free to email debbie@nhbsr.org.

Speaker First Name (as you want it to appear on the website)*

Speaker Last Name (as you want it to appear on the website)*

Email*

Will not be shown on website.

Speaker Title (as you want it to appear on the website)*

Session Owner?*

Yes

Speaker Role*

Moderator

Speaker

Panelist

How many speakers/panelists in this session (total)?

Each speaker or panelist will need to submit this form.

Company website

LinkedIn Page URL

Debbie Roy will send a friend request. Please accept so we can tag you in session promotions.

Facebook Page

Other Social Networks

Speaker Bio (up to 250 words)*

Limit 1200 characters)

Upload Speaker Image/Headshot*

Accepted file types: jpg, gif, png, pdf, Max. file size: 2 MB.

PNG or JPG (Max size 1 MB)

Additional Photos

Max. file size: 4 MB.

Please upload up to 4 photos. (Optional)

CAPTCHA

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