Participate As Speaker - Industry Platform

Participate As Speaker

Nominate a Speaker

First Name*

Last Name*

Corporate Email*

Phone*

Industry Type*

Company*

Job Title*

Proposed Speaker (indicate “As Above” if you are the speaker)

Speaker Company

Speaker Job Title

Speaker Corporate Email

Industry Type*

Topic*

Speaker Biography (150 words or less)*

Attach Speaker Photo*

Please provide image dimensions of at least 600 by 650px