Request a Speaker

konrad reinhart giving a presentation on sepsis at a medical congress Kopie.jpg

Looking for a GSA representative to speak at your congress or event? Please complete this form to submit your request. Please permit up to two weeks for a response, and please note that due to our small size, we may not be able to accommodate your request.

Organization

Contact Person

First Name

Last Name

Email Address

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Phone Number

Country

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Event Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Event Date

YYYY

Event Time

Hour

Minute

Second

Time Commitment

Language of the Presentation

Audience Size

Event Focus

Request Type

Speaking Topic

Travel Expenses Provided

None

Air / Train Travel

Hotel

A/V Equipment Available

Projector

Screen

Speakers

None

Do you need the speaker's bio?

Do you need the speaker's picture?

Will press be present?

Anything else?

Please note that you agree to our privacy policy by requesting a speaker.