Speaker Registration

Please complete the below fields and upload a portrait photograph of yourself to this Google Drive folder. Please include your name in the file name while uploading. This photo will be used in your Badger Talks profile on badgertalks.wisc.edu

Email*

First name*

Last name*

Pronouns*

Salutation*

Job Title*

Speaker Classification*

Area of Expertise for Website (please limit to 60 characters)*

Name of College or Division (Please include all that apply)*

Name of School, Department, Office or Lab*

Office Phone Number*

Cell Phone Number (For internal use only)*

Office Mailing Address (Please include City, State and Zip)*

Are you with the Division of Extension?*

Yes

Extension Faculty/Staff Only: Please list your Extension Area (1 - 22)

Extension Faculty/Staff Only: In what town/city is your local UW Extension office (home base)?

Home Address (Please include City, State and Zip)*

Speaker Biography (2-5 sentences)*

Your Hometown, Born or Grew Up There

Have you submitted a photo of yourself to the Google Drive folder? (Details at the top of this form)

Threads and/or BlueSky username/link to your profile

This will be used to tag you in posts about any talks that you do! We also keep an eye out for social media posts about our speakers' achievements (awards, new publications, etc.) and share them.

Facebook username/link to your profile

This will be used to tag you in posts about any talks that you do! We also keep an eye out for social media posts about our speakers' achievements (awards, new publications, etc.) and share them.

LinkedIn username/link to your profile

This will be used to tag you in posts about any talks that you do! We also keep an eye out for social media posts about our speakers' achievements (awards, new publications, etc.) and share them.

Subtopic Areas for Website

Based on the topic areas selected above, please choose an applicable subtopic(s) in the linked document and copy paste into the text box below.

Talk title (Please keep under 35 characters!)*

Talk description <50 words*

Please make sure the description is written in language that is accessible to the general public!

Talk Title 2 (Please keep under 35 characters!)

Talk description 2

Please make sure the description is written in language that is accessible to the general public!

Talk Title 3

Talk description 3 (to additional talk titles/descriptions beyond 3, please talks 4+ to this form)

Please make sure the description is written in language that is accessible to the general public!

Preferred Talk Type*

I prefer to give in-person talks only

I prefer to give virtual talks only

I can give both virtual and in-person talks

Comments about preferred audience, types of events and/or group size

Are there other languages you speak in which the presentation could be offered? If yes, please specify.

We occasionally have host groups offer a stipend for speakers. Would you prefer a stipend for your talks?*

Is there a limit to the distance you'd prefer to travel (in miles)?

In general, speakers are asked to bring their own laptops to host venues. The venue is asked to provide cables for mac or windows to connect to projector, screen and sound. If you do not have a laptop, or have other requirements as a general standard, please note here.

Risk Management Authorization: Most of our talks require speaker travel. In order to be covered by the State's liability protection while driving on University business, all UW-Madison drivers must be approved through Risk Management prior to departing on University business. Regardless of whether you are driving your personal vehicle, UW fleet car or rental vehicle, all potential drivers must complete the driver authorization request form. The authorization process takes about 10 days to be completed. See the Speakers Resource Guide (or the Speaker Resource Guide for Emeritus speakers) for more info or visit the Risk Management website for more information on driver authorization policy. For current UW employees, to check driver status, you must be logged into My UW. Then, visit https://fleetportal.wi.gov/ Type of employee: UW UW Campus: UW Madison Click "Reports" and "Driver Summary" to see if you are authorized. To register, visit https://fleetportal.wi.gov - Given the requirement outlined above, please select the statement below that best fits your current status.*

Comments and/or questions about driver authorization

REQUIRED: 'I have read and understand the policies listed below' Badger Talks Policies: A UW Connects statewide outreach program, Badger Talks covers travel costs for faculty and staff who give their time to participate in this important outreach effort, including mileage/fleet vehicle costs, meals and overnight accommodations (if necessary). There is no charge to hosting groups, however those organizations are required to cover any costs of arrangements for room setup and additional equipment. Badger Talks accepts event requests 30 days or more in advance to allow sufficient planning time for all involved. As a Badger Talks speaker, you are not required to accept every speaking engagement that is presented to you. Once you have committed to giving a talk, however, you are required to notify us within 3 days of the event if a conflict emerges. Hosting groups are also required to provide this same advanced notice in the event of an unforeseen conflict impacting a scheduled talk. At this time, only current UW-Madison faculty, including Emeritus, UW staff or graduate students are eligible to be speakers with Badger Talks. Speakers who are registered may decide to withdraw their registration at any time if changes in their availability preclude them from participating in Badger Talks events. For your records, you will receive an e-mail including Badger Talks policies and the information you submitted on this form. If at any point you have updates to this information, please do not resubmit a form. Instead, contact Badger Talks staff at 608-262-3880 or BadgerTalks@uwmad.wisc.edu *

Speaker Demographic Information (optional):
Please help us track how Badger Talks reflects the gender, racial, and ethnic diversity of our campus by answering the optional questions below:

Gender (optional):

Ethnicity (optional)

Race (optional)

Do you have any disability-related accommodation needs you would like the host group to be aware of?