Speaker Application

Speak at an Upcoming WSRC Event

If you are interested in speaking at a future WSRC event, please complete the application below.

Upcoming Events

Presentation Info

Presentation Title

Subject Area

Presentation Overview

Presentation Objectives

Objective #1 *

Objective #2 *

Objective #3

Objective #4

Objective #5

Objective #6

Presentation Requirements

Terms & Conditions: By completing and submitting this contract you agree to the following: The WSRC is not liable for the content of your presentation(s). As such, any claims made within are the sole responsibility of the presenter(s). This includes, but is not limited to content accuracy, plagiarism, and/or copyright infringements. Any legal claims made to the WSRC, WSRC, and/or MSRC regarding your presentation will be the sole responsibility of the presenter(s) and will be directed as such.

Conflict of Interest Statement: To ensure that all educational activities are free from bias, all presenters must declare vested interests. Please ensure you include a slide at the beginning of your presentation disclosing any real or perceived conflict of interest as by the American Association for Respiratory Care (AARC).

PowerPoint Requirements: All PowerPoint presentations must be on non-company/industry branded slides.

AV Requirements: The WSRC will provide a standard AV setup that includes: a laptop, room sound, a lapel microphone, a laser pointer, and an audience microphone. Please bring your presentation on a flash drive rather than a laptop as this makes the turn-around time between speakers much easier. If you have unusual video/sound needs or other AV type concerns, please let us know so we can prepare appropriately.

Images and Recordings: The WSRC may post pictures of you presenting on our website or social media pages. We will NEVER record you presenting without your consent. If you are uncomfortable with us sharing occasional images of you, please let us know upon arrival and we will adjust our practice.

Honorarium

I would be presenting via sponsorship from:

Travel and Accommodations

The WSRC committee will review your application and provide travel and accommodations as needed.

Airfare is provided for those living more than six hours away from Wisconsin Dells, WI and will include expenses for round-trip, coach airfare from the speaker's hometown/preferred airport to Madison, WI. You are responsible for booking all flights and submitting receipts to the WSRC Committee Chairperson.

If flying in, ground transportation from the Madison, WI airport (MSN) to Wisconsin Dells, WI is included. You are responsible for booking your own rental car and submitting all receipts to the WSRC. The WSRC will reimburse up to $60/day. Anything over that amount is your responsibility.

You will be reimbursed mileage to and from the conference for using your personal vehicle at the current IRS rate.
I estimate my travel miles to be:

The WSRC Committee will assure reservations are made for a king-sized, non-smoking room in your name for one night.


The WSRC Committee will assure reservations are made for a king-sized, non-smoking room in your name for two nights.



Please reserve a room for the following additional nights at my own expense:

Additional Comments

Submit

Presenter Info

First Name * (As it will appear)

Last Name *

Phone *

Email *

Credentials *

Job Title

Biography *

Please provide a short bio (NOT a CV). This is by the American Association for Respiratory Care (AARC) for obtaining continuing education credits. In addition, we will use this on our website or social media platforms to promote/highlight your presentation.

Professional Headshot

Business/Organization *

Address *

City *

State *

Zip *