NDCEL Keynote Speaker Application

Thank you for your interest in serving as a keynote speaker at one of our upcoming events. This form allows you to share your background, message, and availability so we can consider the best fit based on audience and event themes. Keynote opportunities are limited and selected based on alignment with event goals and speaker experience.

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Name (First & Last) *
Organization/Company *
Contact Name (if different from Presenter) *
Contact's Email *
Mailing Address *
Phone Number *
Proposed Keynote Title *
Please provide a brief description of the presentation you propose to deliver at an NDCEL Event. Include key topics, themes, and objectives. How will this topic relate to administrators? (Please limit your response to 300-500 words). *
Describe any interactive elements or engagement techniques you incorporate to ensure active participation. 
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Who is your keynote best suited for? (check all that apply) *
Required
Are you open to other opportunities during the event? (check all that apply)
What is your fee for delivering the proposed keynote?
Please specify if your fee includes travel, accommodation and/or any other expenses. 
Are any discounts available for educational or non-profit organizations.

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Please provide a link to your website or any online videos showcasing your previous presentations or speaking engagements. This will help the selection committee assess your speaking style, content delivery, and relevance to our audience.
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Please provide at least two references who can speak to your experience as a keynote speaker.  (Name, Email, Contact #)

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Do you have any specific requirements or preferences regarding venue setup, audiovisual equipment, or other logistical arrangements? Please provide details to help us ensure a smooth and successful event.
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Any other comments or details that set you apart from other speakers?

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