Pecha Kucha Application Form
Contemporary Glass Society - Glass in Wales Symposium
Name
*
First Name
Last Name
CGS/BSMGP Membership Number
*
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Location
*
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Outline of your talk for the Pecha Kucha
*
0/200
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of
Details of image, including photo credit
*
File Upload
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Details of image, including photo credit
*
File Upload
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Details of image, including photo credit
*
Please confirm you have purchased a ticket for the event
*
Yes
No
I will if I get selected for the Pecha Kucha
I'd love to talk, but I can't afford a ticket
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