Speaker Informational Form

Thank you for agreeing to serve as a presenter at our upcoming annual conference.  The following will assist us in the preparation of our notebook and mobile application.  If you have any questions, please contact your Workshop Coordinator.

Speaker Information

Workshop Information

Workshop #2 (if applicable)
Workshop #3 (if applicable)
For introduction - 200 words or less

Audio/Visual Needs

All rooms have the following:

  • Table microphones
  • Lectern and lectern microphone
  • LCD projector and screen

Laptops are NOT provided.  Speakers must provide own computer equipment for use with LCD projector.

If you need other items Please indicate below: (please provide justification)

Sign Release

By submitting this form, you agree to the following Release.

Grant of Rights: I authorize Eastern Regional Interstate Child Support Association (ERICSA) the following rights to the Work:

  1. the right to reproduce and publish the Work, or any part thereof, in any medium or form of communication in the English language throughout the world, and to reprint whenever necessary;
  2. the right to use the Work, or any part thereof, in any other publication produced by ERICSA.

Authors’ Use of Work: ERICSA grants you permission to reprint the Work or portions of it in other scholarly or professional publications.

Warranty: You warrant that the Work is original with you, that its publication will not infringe on the rights of others, and that you have full power to make this agreement.

Previous Publication and Permission: You warrant that the Work has not been published elsewhere in whole or in part (except as may be set forth below) and that no agreement to publish the Work or any part thereof is outstanding. Should the Work contain any material which requires written permission for inclusion in the Work, or should the Work require written permission to be reproduced by ERICSA, you agree to obtain such permission from the copyright proprietor and to provide ERICSA with a copy of the reprint permission.

Please be advised that ERICSA reserves the right to use your name, photography, and presentation title in marketing material promoting the conference.