Speaker Submission for EBMI – Electrical Board of Missouri & Illinois

EBMI Speaker Submission & Course Proposal Form

Thank you for your interest in presenting for The Electrical Board of Missouri and Illinois (EBMI). This form allows you to submit a proposed course/seminar along with supporting details for review by our Education Committee. Submissions will be evaluated based on relevance to our industry, quality of materials, and speaker expertise. Please provide complete information so we can fairly review your proposal.

Name(Required)

First Last

Email(Required)

Enter Email Confirm Email

Organization/Company

Phone number

Please provide a phone number in the case we need to contact you the day of the event/program.

Job Title

Mailing Address (optional, if needed for follow-up or payments)

Course/Presentation Information- Proposed Course Title

Description (Please provide a brief description of course/presentation)

Include 3 bullet points to be included on advertising materials.

Target Audience (e.g., industrials, distributors, contractors, engineers, project managers, apprentices)

Learning Objectives (3-5) key takeaways participants will gain)

Course Length (in minutes/hours)

Format

In-Person

Webinar

Hybrid

Materials & Requirements- Will you provide participant handouts/materials?

Yes- if Yes, upload option

File

Max. file size: 64 MB.

Do you require A/V or special equipment?

Yes-please communicate details

Speaker Credentials- Brief Speaker Bio (100-200 words)

Professional Credentials / Licenses / Certifications

Upload Resume or bio and profile pic to be used in program brochure.

Max. file size: 64 MB.

Compensation & Fees- Would you require a speaker fee or honorarium (Yes/No). If yes, please specify amount range.

Miscellaneous- Additional Information (anything else you would like the committee to review)

Please let us know what's on your mind. Have a question for us? Ask away.