Speaker Request Form – Next G Alliance

Speaker information

Please include speaker name, title, company, and Next G leadership if applicable.

Event name

Event website

Is this event face-to-face or virtual?

Event location

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Date

Time

Session title

Session description

Is this a panel discussion?

Please list the other speakers on the panel.

Event social media

Please include relevant social media accounts and hashtags.

Event logo

Click or drag a file to this area to upload.

Event producer/contact name *

Phone

Email *