Soil Health 2021: Speaker Questionnaire
Please respond as soon as possible so that we can be sure your requests are met without issue.
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Soil Health Conference, February 17-18, 2021
Thank you for agreeing to speak at the Soil Health Conference. Please complete the following information to allow us to make arrangements as needed for you.  If you have any questions, please contact Aubrey Robertson (Ames CVB/Iowa State University Conference Planning & Management) at aroberts@iastate.edu or 515-956-3202. Please respond as soon as possible.
Speaker Information
First Name *
Last Name *
Company/Organization *
Job Title
Address, City, State *
Email *
Mobile Phone *
Please describe all accommodations needed, such as for dietary needs and/or mobility and sensory disabilities *
Travel Questionnaire
Would you like to have the conference manager reserve lodging for you? *
If YES to the question above, please provide which nights you wish to reserve. (Note: if you will fly in, your hotel booking will be made in accordance with your flight itinerary.)
How do you plan to travel to the conference?
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Will you need travel expenses to be reimbursed by the conference? *
Do you require an honorarium? *
Amount of honorarium, when applicable:
Presentation Questionnaire
Presentation Title *
Presentation A/V needs beyond laptop, wired microphone and digital projector: *
Does the conference have your permission to make a  of your presentation available online after the conference (in a protected format)? *
May staff take your photograph during the conference? *
Do you anticipate needing any materials/handouts printed for conference attendees? *
Please provide a a few sentences on your professional background and qualifications for this particular presentation. This will be used to introduce you to conference attendees. *
Please provide a a few sentences describing the topic you will cover. This will be used to market the conference to potential attendees by providing conference highlights. *
Any questions or additional requests pertaining to conference coordination, please direct to Aubrey Robertson at aroberts@iastate.edu
The information you provide will only be used for registration purposes. As a speaker, your registration is complimentary and will be completed for you by Registration Services using information provided on this form.
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