First Name (required)

Last Name (required)

Company / Firm Name (required)

Address (required)

City (required)

State (required)

Zip Code (required)

Phone (required)

Phone Extension

Mobile Phone (required)

Your Email (required)

If your application includes a panel, please provide the name, company, phone and email contact information for all of the panelists here.

CE
We intend to apply for CE credit with CA, FL, OK and TX for this conference. In order to obtain CE credit we must apply to each state prior to the conference. This means you will have deadlines several months prior to the conference for submissions of outlines, PowerPoints, bios, summaries, etc. These submissions can change for your presentation, but we must have a current version of the documents requested by the deadlines provided.

CLE
Please list the state(s) and bar number(s) after your name for any state you require CLE for conference attendance.

The speaker applying should be the person intending to present at the conference, as FETTI does not allow substitution of the approved speaker.
Speaker Qualifications: (Years in specialized industry, degrees, certificates, other recent speaking engagements, etc…).

Have you spoken at any other industry events?
YesNo

If so, which program(s) and on what topic(s)?

What topics would you be interested in presenting? Please identify the topic(s) below and attach an outline for each topic, providing detail.

Are you willing to prepare an article and PowerPoint to support your presentation?
YesNo

Please attach a speaker bio, outline and any other pertinent materials to this form. You will be contacted if you have been chosen to speak.
*The following file formats are accepted: .pdf, .txt, .ppt, .pptx, .doc, .docx

Please only click the submit button once; it may take up to 5 minutes to process and upload attachments.

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