Please complete the Request Form as fully as possible and provide the following information in your message:

1. Who is your audience (academic/business)?

2. What is your expected audience size?

3. Type of Organization (Non-Profit or For-Profit)

4. Registration Fee for Attendees?

5. What are your speaker benefits (honorarium/travel expenses/guest allowance)?

Request Form

For speaking engagements, we appreciate at least three weeks notice for events outside the East Coast or International events

DR. MANSUR HASIB

GLOBAL AWARD WINNING CYBERSECURITY EDUCATION LEADER, AUTHOR, AND SPEAKER

Name: *

Location of Event:

Email *

Check here to receive email updates

Event Name:

Organization Type *

For Profit

Non Profit

Speaker Benefits *

Audience Size

Length of Time and Desired Topic(s)

Registration Fee for Attendees: *

Date of Event: *