Create Speaker Profile

Create your Secure360 Speaker profile. (New users only. If you have submitted in the past, please choose "log in" on the right).

Name*
First Last
Company*
Job Title or Function*
Email*

IMPORTANT: This needs to be the email address of the SPEAKER. If this form is being filled out by an assistant, please specify assistant's email address in the appropriate field lower down on this form.
Phone*
Username*
Do NOT use your email address as your username as it cannot be changed in the future.
Password*
Enter Password Confirm Password
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Speaker Bio*
Less than 200 words/1000 characters
Example of Presentation Ability
Drop files here or
Please upload a file showcasing your previous presenting experience. If you do not have a video of a past presentation, please upload a new video with the following information: who you are/who you work for, why you are an expert on your presentation topic, and what your delivery style is (PowerPoint, discussion-based, freeform, etc.)
Speaker Picture
Accepted file types: jpg, gif, png.
Is this profile being created by someone other than the speaker?*
If so, please enter submitter contact details in fields as prompted.
Submitter Name*
Submitter Phone*
Submitter Email*
Twitter Handle
Just the username, NOT the "@" or the "http://" parts. For example: "secure360"
Would you be interested in speaking at other events hosted by member organizations of UMSA?*

Footer