Conference Speaker Application form

Primary Speaker's Name

First NameLast Name

Company Name as Applicable. If not applicable place a N/A in the box.

City*

Your Industry*

Job Title

Your Web Site

Lets Get Social:

E-mail*

Confirmation Emailexample@example.com

File Upload: Dimensions :1080 x 720file size ideally shouldn’t be above 100kb

The title of your session is the first impression for Conference Attendees. Use a concise, but inclusive, title which clearly conveys what you will be presenting and draws attendees' attention to your topic.

Title of Your Session:*

Abstract: Your session abstract will tell Conference Attendees why they should attend your session. To be effective and create interest, it should provide a brief, clear, and concise reflection of your presentation’s content. The abstract should only be one paragraph of between 150 to 250 words in length*

Outline Your Key Elements. List 4 to 5 primary or key elements of your topic that you will be discussing.*

Target Audience*

Have you given this presentation before and/or you do you intend to present it elsewhere in the near future?*

If YES, please list where and when - If NO place N/A in the box.*

Please provide references with phone number or email - If NO place N/A in the box.*

Bio for Speaker # 1*

Speakers Name # 2

Bio for Speaker # 2

Speakers Name # 3

Bio for Speaker # 3

I agree to submit my presentation prior to the Conference *

I have verfied that all information provided is accurate. and complete*

Yes

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