2024 Speaker Intake

Thank you for agreeing to be a speaker at the 2024 REGENERATE Conference! We are excited to have you join us. Completing the following form will provide us with the details to ensure you are represented in our conference materials accurately. If you have questions or need help with this form, please contact Leah Potter-Weight: leahpw@quiviracoalition.org

Speaker Information

Items marked with a + will be included on the conference website and in the program.

Name +(Required)

First Last

Pronouns (optional)

Email(Required)

Email +

Please enter the email address that you would like to have listed in the conference program. Write none if you would like no email listed.

Phone(Required)

Primary Title and Affiliation +(Required)

The primary title and affiliation you enter here will be included on the conference website and virtual platform, and in the program. You have the option to submit a secondary title and affiliation below. If space allows, we may list the second title and affiliation, as well.

Secondary Title and Affiliation

Mailing Address(Required)

City State / Province / Region Country

Photos +(Required)

Drop files here or

Accepted file types: jpg, jpeg, tif, png, gif, Max. file size: 50 MB, Max. files: 4.

Please upload a headshot and/or photo(s) of yourself doing the work you love! You can upload up to four photos in the following formats: JPG, JPEG, TIF, PNG, and GIF. The maximum file size allowed for each photo is 50MB.

Personal Bio +(Required)

1500 characters maximum. Please note that we will copyedit and proofread your bio before posting it, but we will not alter its content.

Website +

Would you be willing to be a guest on a Quivira podcast, (Down to Earth and/or Regeneration Rising)?

Yes

No thanks

We will work with your availability to schedule this.

Have you published books, papers, articles, or videos that you'd like us to include on your speaker page?

Yes

Please list the title(s) and/or URLs of your publications. +

Social Media Links +

Please list links or handles to social media accounts that you would like to be linked in Regenerate conference outreach.

Presentation Information

Please share your title/description. Things to consider in forming them are your passions, background, current projects; our conference theme of Innovating for a Resilient Future; and some of the interests we outlined in our initial communications. You are welcome to change the title/description later. We have stand-in titles for all presenters which we will use until/unless you share your title with us via this form or email. If you want help deciding your title, or want to send it to us later, please email Leah. We will be scheduling meetings with all speakers over the coming months, so we can refine your presentation details then if needed.

Title of your presentation:

Short presentation description (3-5 sentences):

Scheduling and Roundtables

The 2024 REGENERATE Conference will take place Nov 6-8 in Denver, CO. The main conference speaker sessions will take place between 8AM and 5PM on Nov 7 & 8. We encourage your participation throughout the entire conference, but we recognize this may not be possible.

I am available all day on the following days: (check all that apply)(Required)

Thurs Nov 7

Fri Nov 8

We will inform you of the final schedule as soon as it is set.

Do you have any scheduling conflicts on Nov 7 or 8 that we should be aware of?

Are you interested in participating in any roundtable discussions?(Required)

Yes, I'm interested in participating in a roundtable, but only one

Yes, I'm interested in participating in two roundtables

No thank you

Not sure - I'd like more info

Facilitated roundtables will take place Nov 7 in the afternoon and Nov 8 in the morning. They are an opportunity for speakers and participants to interact in in-depth discussion on topics related to your presentations. We may repeat the same topics twice. Please let us know if you're willing to participate in at least one ~70 minute roundtable. We also plan to have a lead facilitator (non-speaker) at each roundtable unless you have explicit interest and background in facilitation.

Payment Logistics

Quivira Coalition is excited to pay you an honorarium and reimburse your travel. In order for us to process this payment, we need a bit of information. Speakers are asked to book their own travel. After the conference, please upload all travel receipts to the Speaker Travel Reimbursement form, which we'll send after the conference. If you need support booking travel please reach out to us. We cover lodging for all speakers and will book you at our preferred hotel unless you note otherwise on the forthcoming conference registration. Speakers will be paid after the conference. After you submit your travel receipts, payments typically take 2-4 weeks to be processed. If you need an expedited payment, please let us know! If you have any payment related questions please contact our OPS team at admin@quiviracoalition.org.

Who/What organization ("Payee") is to be paid?(Required)

Please enter who/which organization/business the payment is to be made payable to. This is equivalent to the name a check is written out to.

Preferred Method of Payment(Required)

Check (via Bill.com)

E-payment (via Bill.com)

Speaker will send Quivira an Invoice (which receives electronic payment)

Quivira uses Bill.com to process payments. We can either cut you a paper check or make an e-payment (aka ACH or EFT to your bank account). Please let us know which one you prefer. Alternatively, if you would like to generate + send Quivira an invoice that accepts electronic payments (i.e., Quickbooks or Square...), Quivira can send payment via that system which would eliminate the need to get Bill.com set up.

Please check this box if you have a different mailing address for payment than the address entered above.

Enter a different address

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Bill.com Payment Network ID#

If you chose e-payment and you are already set up in bill.com plus know your Payment Network ID#, please add it here. It will just allow us to connect to you faster. If you don't know it don't worry. If you aren't set up we'll send you an invite.

Thank you!

We will be in touch again soon to confirm exact dates, speaking times, and roundtable details. We'll also send you the registration form once it is launched.

Anything else you want us to know at this time?

Name

This field is for validation purposes and should be left unchanged.