Online Speaker Registration Form
Online Speaker Registration Form
Please fill out this form to register as a speaker for our upcoming online event.
Personal Information
Name
Phone Number
Organization/Company (if applicable)
Job Title/Position
Speaker Profile
Brief Bio
Provide a short professional bio for introductions.
Headshot (if required)
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Attached
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To be submitted separately
Upload Supporting Files
Upload any relevant files, such as photos or documents
Social Media/Professional Links
Insert your LinkedIn, Twitter, or other relevant links.
Presentation Information
Proposed Topic Title
Topic Description
Provide a brief description of your topic or key points.
Target Audience
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Students
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Professionals
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General Public
Presentation Format Preference
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Live Presentation
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Pre-Recorded Presentation
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Panel Discussion
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Workshop
Session Requirements
Please specify any technical needs or presentation materials required for your session.
Audio/Visual Needs
List any specific audio/visual requirements.
Additional Materials
Indicate any files, slides, or handouts you will need.
Availability
Please indicate your availability within the event schedule.
Preferred Date and Time
Additional Information
Please provide any other relevant details or special requests that will help us make your session successful.
Emergency Contact
Name
Relation
Phone Number
Speaker's Signature
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By signing below, I confirm my commitment to participate as a speaker and agree to follow the event guidelines and schedule.
Name:
Date:
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