Book Speaker

Thank you for your interest in the Academy of General Dentistry's (AGD) Speaker's Bureau.

If you are interested in booking an AGD Speaker’s Bureau speaker, please complete the following fields to submit an inquiry to staff.  You must provide the following information: speaker, course type (lecture or participation, if available), location, and date desired.  Your inquiry will be sent to AGD Staff, who will contact the speaker directly to learn their availability and interest.  AGD Staff member will follow up with you within 7 business days.

Please fill out the form below		Required
Your name
Your AGD membership ID
Your office phone
Your e-mail
Select the desired speaking date		1st 2nd 3rd
Location of meeting
Additional comments
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