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Request a Broadband Forum Ambassador

General Information:

  

Company

First Name

Last Name

Title

Address

City

State

Zip

Country

Phone

Fax

e-mail address

SECOND CONTACT:

First Name

Last Name

Phone

Fax

e-mail address

 

Event Details:

 

Date(s)


Begin Time

Duration

Held At: City

State


Facility Name


Event Name:

Request For:
 
Single Presentation Multiple Presentations
Speaker Panel Chair a session
Other
 

Event:
 
National/Regional Conference International Conference
Other
 

Expected Size of Audience:
 
1-25 26-50
50-100 100+

Expected Type of Audience:
 
High Level Mixed
Technical
 

Expected Audience Current Understanding of DSL:
 
No Knowledge Little Knowledge
Knowledge of DSL Extensive Knowledge of DSL


Please further describe the event and audience:


Is the audience representation of a specific industry or interest group? Check all that apply:

Health
Insurance
Finance
Manufacturing
Government
Telecommunication
Higher Education
SOHO
Video on Demand
Internet Gaming
High Speed Internet Access
Other
 

Please select the Ambassador Presentation that applies to your event:

ADSL Overview
ADSL Tutorial
Universal ADSL
VDSL Technical Information
Packets/Frames Over ADSL
ATM over ADSL
Other
 

Preferred Language for Presentation:

English
Other
 

If this presentation is part of a conference, will the conference fee be waived for the speaker(s)?

Yes
No

If no, what is the fee?

For National conferences where a conference fee is charged and an Ambassador(s) speaker participates, it is expected that the conference contributes to the Ambassador's travel expenses. Can you reimburse the speaker for:

Travel?
Yes
No

Hotel?
Yes
No

If so, how many nights?

Meals?
Yes
No

When multiple Ambassadors are speaking at the same event, their travel must be compensated equally.

How did you learn about the Broadband Forum Ambassadors Program?

If this presentation is part of a larger agenda, please e-mail us a copy of the agenda.