Beyond Safety Conference Speaker Application

We invite you to submit an application to speak at the 2026 Beyond Safety Conference on February 3, 2026 at Blue Chip Casino in Michigan City, IN.
Name*

First NameLast Name
Email*
example@example.com
Company/Organization*
Title/Position*
Phone Number*
Please enter a valid phone number.
Your website*
Presentation Title (Be creative & attract a crowd)*
Presentation Description (Describe presentation and define three takeaways that attendees will learn from your presentation - 200 words max.)
Speaker Bio

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Speaker Reel

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Do you have any books, materials, etc. that you'd like to sell at the conference?

YesNo
Are you available February 3, 2026?*

YesNo
Please upload a Headshot

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Business Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please fill out below if you are nominating a speaker that is not yourself.
Name

First NameLast Name
Company/Organization
Business Phone
Please enter a valid phone number.
Business Email
example@example.com
Should be Empty:

Apply Today!

Applications are being reviewed on a rolling basis. Apply early to secure your spot in this transformative event.

Deadline for applications is June 15, 2026

Beyond Safety Conference Speaker Application

Please fill out below if you are nominating a speaker that is not yourself.