IDSA Speaker Request Form
Information and Guidelines
This form can be used to request an IDSA Speaker for your event.
IDSA Speaker Request Guidelines & Information
Time Frame
Requests should be made at least 60 days prior to the event
We are unable to accommodate requests made more than 12 months in advance
Cost
No fees, stipends, or honoria is required; this is a free benefit for Affiliates of IDSA
Expenses
For Affiliates of IDSA, travel expenses and incidentals are covered by IDSA
For non-Affiliates of IDSA, travel expenses and incidentals are covered by the sponsor organization
Sponsor organization is responsible for covering lodging expenses
Miscellaneous
An agenda of the event is desired (draft agendas are acceptable)
IDSA or IDSA Foundation staff may be able to participate in the event as well and will contact you after you submit the details of your event
Contact Information
Sponsoring Organization:
Mailing Address
(Street, City/Town, State and Zip Code)
This will be an address where any swag or paraphernalia can be sent
Contact Name:
Contact
Title:
Contact
Email:
Contact
Phone:
Website address (if applicable):
Event Information
Event Name:
Start Date (MM/DD/YY) & Time:
End Date (MM/DD/YY) & Time:
Location:
Theme/Purpose of Event:
(CME, Annual Meeting, Symposium, etc.)
Speaker Start & End Time:
Length of time allotted for presentation:
In-person or virtual?
Expected Attendance (#):
What is the attire?
(Formal, Business, Business Casual)
Invited Audience:
ID Physicians
Fellows
Students
Other
Check all that apply
Explain other invited audience
Presentation Specs
Presentation Format:
Keynote/General Address
CME Presentation
Panelist
Installation of Officers
Presenting of Award(s)
Roundtable
Other
Please specify:
Topic Area:
Do you have a preferred speaker from the IDSA Board of Directors?
Yes
No
If so, please share name of IDSA Board Member
IDSA will do it's best to accommodate requests, but it is dependent on schedules, availability, and event type.
Will the following AV equipment/services be available? (check all that apply)
LCD Panel/Screen
Computer/Laptop
AV Support
Room set up:
Classroom style
Banquet style
Theater style
Other
Do you need us to supply any of the following? (check all that apply)
Speaker Bio
Speaker Headshot
Speaker Slides/Presentation
Please provide a copy of your draft agenda
Would you be open to sharing an attendee list with IDSA after your event?
Yes
No
Would you be open to sharing pictures or a link to any pictures from the event?
Yes
No
Contact Information