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Form for PACES Collaboration Requests
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* Indicates required question
Email
*
Your email
Organization requesting PACES collaboration:
Your answer
Name of the conference (if not known, please describe conference purpose):
Your answer
Date(s) of the conference:
Your answer
Name of contact person for the requesting organization:
Your answer
Email of contact person for the requesting organization:
Your answer
How many PACES speakers are you requesting?
Your answer
How long should the requested talks be in duration?
Your answer
What topics would you like the speakers to discuss or do you have a talk title in mind?
Your answer
If the requested talk(s) are part of a larger session, please give the title of the session and list the topics of the other talks included in the session
Your answer
Does the requesting organization agree to officially acknowledge the PACES collaboration for the session(s) involving our PACES speakers?
Yes
No
Clear selection
Format of the conference:
Virtual, all pre-recorded
Virtual, pre-recorded talks with live virtual Q&A
Virtual, but all live talks and live Q&A
In Person
Hybrid
Clear selection
If Virtual with pre-recorded talks, what format will the talks be recorded in? (please leave blank if not applicable):
Your answer
If Virtual with pre-recorded talks, what date is the deadline for speakers to submit their pre-recorded talks? (please leave blank if not applicable):
MM
/
DD
/
YYYY
If the talks are live or if there is a live virtual Q&A, what date(s) and time(s) would the speakers need to be available? Please include time zone
(please leave blank if not applicable):
Your answer
If in person, what is the location of the conference? (please leave blank if not applicable):
Your answer
If in person, is there funding available for speaker travel, lodging, and/or honorarium?
(please leave blank if not applicable):
Your answer
If hybrid, please give more details regarding what will be expected of the speakers (please leave blank if not applicable):
Your answer
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