MSPN Confirmed Speaker Questionnaire

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Thank you for agreeing to speak at our MSPN event. Please complete the following form so we may best prepare for a successful meeting.

Virtual Presentations
First Name *		Last Name *
Professional Title		Credentials
Organization *
Address		City
State		Zip/Postal Code
Phone		Cell Phone *Phone to reach you during virtual meeting times and/or days of travel and on-site at meeting.
Email Address *
Presenter's BioSnapshot (200 words max)This will be used for introduction purposes and on meeting materials.
Presenter's Resume / C.V.Please provide your latest resume / CV
Presenter's HeadshotPlease submit your latest headshot.
*The following questions are relative to virtual presentations.*
What is your comfort level with Zoom Webinar?	Not comfortable / Never Used Somewhat comfortable Very comfortable Max comfortable / I'm a Pro
Do you agree to a scheduled tech check prior to the date of the presentation.	Yes No
Do you agree to allow MSPN to record and provide your presentation for on-demand CE?	Yes No
In-Person Presentations
*The following questions are relative to in-person presentations.*
Planned Day of Arrival at Venue		Planned Day of Departure from Venue
Will you have handouts?	Yes, I will provide them on-site. Yes, I would like MSPN to provide them electronically only. Yes, I would like MSPN to provide them at the live event. No, I will not.
Additional AV RequestsMSPN will provide a podium with microphone, table top microphones for panels, projector and laptop. Additional requests will be filled as we are able to with the venue.	Handheld Microphone Lavalier Microphone Internet Access Audio Feed Other (Please describe below)
Additional Requests
Special Dietary Needs
Additional Comments

Calendar more

11/19/2025
November Webinar: Section 111

12/17/2025
December Webinar: Ethics

CORPORATE PARTNERS

The relationship between The National MSP Network and CMS officials has been invaluable to my business. When the industry identifies concerning trends or questions, MSPN reaches out to CMS to get answers, work through problems and weigh in on potential policy changes. I can always turn to MSPN to help my business navigate these ever-changing waters.

- Amy Bilton

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CORPORATE PARTNERS