Speaker Intake Form 2024 Anarchapulco 2024 Speaker Intake Form Name as you would like it to appear on the website * Name as you would like it to appear on the website First First Last Last Email * Headshot in high quality for the website: * Drop a file here or click to upload Choose File Maximum file size: 314.57MB Title of Talk: * Biography for website * Website/Links/Social Media * Do you agree to the terms of the Speaker Agreement including in relation to event promotion, speaker briefings and communication with Anarchapulco staff? * YesNo Do you agree to participate in mediation in the event of conflict between yourself and Anarchapulco? * YesNo Do you promise to practice the Four Agreements? * YesNo If you are human, leave this field blank. Submit Start Over
