Exit and Build Land Summit IV Speaker Intake FormPlease enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Speaker Name *FirstLastTitle at Business or Organization *Affiliation / Business Name *3-5 Sentence Bio *Attach a Headshot * Click or drag a file to this area to upload. Website *Talk Title *Talk Description & Indicate Preferred Amount of Minutes for your talk *Social Media Pages (Optional)Facebook Page LinkTwitter LinkInstagram LinkTelegram LinkContact Info for our planning teamEmail address *Phone number *Are you able to join us in person at the Bastrop Convention Center to present? *YesNoDo you want to put on a workshop? If so, please describe what you have in mind:Do you want info about sponsorship opportunities?Do you want an exhibitor booth or vendor table in Agora Row?Are you available all 3 days of the conference portion of the event, Friday May 17 Through Sunday May 19? (Interactive farm tours will be the day before & after / May Thursday & Monday May 20 *All speakers are expected to attend the VIP Dinner and can bring up to one additional guest. Can you attend the VIP dinner Saturday May 18th at 6pm? Are you bringing a plus one? If so, please inform their nameAll speakers are expected to promote on social media and share with your email list to help your audience watch your talk virtual or join us in-person. Are you down to share with your audience?Are you interested in becoming an affiliate partner?Submit
