Empowered to tell our own stories Speaker Information Form * indicates required fields First Name* Last Name* Email Address*(will not be visible on the website) Personal Statement*Include your interest in the topic(s), as well are your personal experience with the subject and in public speaking, or any other relevant information to help organizations understand your expertise. (100 word max) Area(s) of Interest / Expertise*Select as many as you wish (at least one). Supported decision-making and alternatives to conservatorships Education and inclusion Communication access Healthcare Racial and ethnic disparities Transportation and accessibility Autism Awareness and Acceptance Month History of the disability rights movement Other (specify:) Other Availability*Select all that apply (at least one) Virtual Presentation In-person Presentation In-Person Availability Location*Select all that apply (at least one) Northern CA Central CA Southern CA National/U.S. International Fee* Upload a Photo*JPG or PNG only. Max file size 4MB.NOTE: For best results, we strongly recommend photos that are square.Accepted file types: jpg, jpeg, png, gif. Photo Preview:
