Canada 2023 Speaker Application

SPEAKER APPLICATION
Main Contact
First Name:*
Last Name:*
Organization:*
Job Title:*
Email:*
Phone Number:*

Country CodeArea CodePhone Number
Address 1:
Address 2:
City:*
Province/State:
Country*
Postal/Zip Code:
Please choose ONE that is most applicable:*

I am submitting a speaking proposal for considerationI would like to speak in my area of expertise and be assigned to a panelI am submitting an interactive workshop proposal for consideration
Please choose all that apply:*

I am willing and able to travel and speak in-person at the event (travel costs are at the speakers expense)I am willing and able to speak remotely via a virtual conferencing platform
Speaker Photo*

I give my permission for my LinkedIn photo to be used in promotion of the event if I do not provide a photo.
Session Information
Session Title or Area of Expertise:*
(Max 80 characters)
Presentation Track:*
Presentation Level:*
Brief description of proposed session or subject matter:*

(Min 50 - Max 150 words)0/150
Choose how many people will be involved in the session (including the moderator) :*

One speakerTwo speakersThree speakersFour speakersFive speakers
Speaker #1 (Presenter/Moderator): Please note: Moderators will be responsible for scheduling their own panel calls in preparation for their break-out session.
First Name:*
Last Name:*
Organization:*
Job Title:*
Email:*
Phone Number:*

Country CodeArea CodePhone Number
Address 1:
Address 2:
City:*
Province/State:
Country*
Postal/Zip Code:
Upload a profile photo (max 20MB, min dimensions 1000 w x 1029 h)*

Browse Files

Cancelof
Biography:*
(Min 500 - Max 1,000 characters)
Speaker #2 (Presenter):
First Name:*
Last Name:*
Organization:*
Job Title:*
Email:*
Phone Number:*

Country CodeArea CodePhone Number
Address 1:
Address 2:
City:*
Province/State:
Country*
Postal/Zip Code:
Upload a profile photo (max 20MB, min dimensions 1000 w x 1029 h)*

Browse Files

Cancelof
Biography:*
(Min 500 - Max 1,000 characters)
Speaker #3 (Presenter):
First Name:*
Last Name:*
Organization:*
Job Title:*
Email:*
Phone Number:*

Country CodeArea CodePhone Number
Address 1:
Address 2:
City:*
Province/State:
Country*
Postal/Zip Code:
Upload a profile photo (max 20MB, min dimensions 1000 w x 1029 h)*

Browse Files

Cancelof
Biography:*
(Min 500 - Max 1,000 characters)
Speaker #4 (Presenter):
First Name:*
Last Name:*
Organization:*
Job Title:*
Email:*
Phone Number:*

Country CodeArea CodePhone Number
Address 1:
Address 2:
City:*
Province/State:
Country*
Postal/Zip Code:
Upload a profile photo (max 20MB, min dimensions 1000 w x 1029 h)*

Browse Files

Cancelof
Biography:*
(Min 500 - Max 1,000 characters)
Speaker #5 (Presenter):
First Name:*
Last Name:*
Organization:*
Job Title:*
Email:*
Phone Number:*

Country CodeArea CodePhone Number
Address 1:
Address 2:
City:*
Province/State:
Country*
Postal/Zip Code:
Upload a profile photo (max 20MB, min dimensions 1000 w x 1029 h)*

Browse Files

Cancelof
Biography:*
(Min 500 - Max 1,000 characters)
Should be Empty:

SPEAKER APPLICATION