Speaker Form

Thank you for lending your expertise to EBAA and for agreeing to present to the membership. As we prepare for your presentation, please submit the required information and materials using the form below. We look forward to your presentation!

Name

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

Name

First Last Designation

Phone Number

Organization/Eye Bank

Job Title

Brief Bio

Enter a brief bio below or upload it using the file upload.

Bio Upload

Drop files here or

Accepted file types: doc, docx, pdf, jpg, Max. file size: 25 MB.

Headshot

Please upload a photo of yourself.

Drop files here or

Accepted file types: jpg, gif, png, Max. file size: 25 MB.

Speaker Agreement

I will submit my presentation to the EBAA office by the due date.

A nonexclusive, world-wide, royalty-free license to record, broadcast, and sell or offer as complimentary your Presentation by conference call, webinar, and/or online broadcast, with accompanying outlines, PowerPoint presentations, documents, and/or handouts (hereinafter, “Materials”) provided by me.

The right to edit, transcribe, duplicate, distribute and sell or offer as complimentary, at EBAA’s discretion, recordings and copies of my Presentation and Materials, in whole or in part, on EBAA’s eyeLEARN website eyelearn.restoresightorg or the EBAA website restoresight.org, or in any and all media now existing or hereafter developed by EBAA throughout the world.

The right to use Presenter’s name and voice, Presentation title, Presentation description and biographical information in publicity, promotion and advertising in connection with the Presentation and the Materials.

I will only include material and content that I have obtain permission to use and will cite material from outside sources.

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