SAGE - Request A Speaker

Would you like to request a SAGE speaker for your event? If so, please fill-out the form below and your request will be immediately forwarded to the SAGE Speaker-Recruiter.

Note: please give us several weeks lead time to find the most appropriate speaker for your event. Every effort will be made to supply speakers on shorter notice, but we may not be able to honor your request.

(* indicates a required entry)

Requestor Name*
Requestor Email*
Requestor Phone*

INFORMATION ABOUT SPEAKING ENGAGEMENT:
Date(s)*
Time(s)*
Organization Name*
Organization Address*
Purpose of Event*

Contact information for the person who will be our liason for the event (if different than requestor):
Name
Email
Phone

Do you prefer a speaker with work experience in a specific industry? If so, please check all that apply.
High Tech Hardware Software (e.g. database, software engineering, systems analyst) Database Systems Telecommunications Ecommerce/Internet (e.g. web design) Life Sciences & Pharmaceuticals Consulting Science/Research (e.g. chemist, clinical laboratory, physicist) Engineering Math/Finance Law Medicine Other

Do you prefer a specific job title? If so, please check all that apply.
Professional non-managerial Manager Executive (SVP, EVP, VP) Senior Executive (President, CEO, CFO, CIO) Consultant Owner Other

In order to find the most apppropriate speaker for your school or organization, please tell us about: the audience (age, gender, etc.), audience size, audience's level of experience with subject of presentation, topics you'd like covered, and any other special requests that you have.

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