SPEAKER NOMINATION FORM


BEFORE YOU FILL OUT THE FORM BELOW...

READ THESE THREE THINGS:

ONE

There are no plans for any information that you provide below to be distributed to any third parties but you will be notified if this changes in the future (unlikely).

 

TWO

All information that you provide in this form will be uploaded directly to the speakers page as you provide it. So the more information you provide, the better. And the better quality the information you provide, the better. 

 
 

THREE

Please do not fill out this form if you are uncomfortable with any of the information you detail being added to your speaker's profile.

 

You can call me: *
You can call me:
I entered the World on this date: *
I entered the World on this date:
I identify my gender as: *
What is your job title?
Where do you work?
Payment for travel expenses must be negotiated between you and the event organiser
I speak the following languages: *
Please tick all languages that you are comfortable presenting in
Have you spoken at events before? What are you an expert in? What is your background?
Your personal website:
http://
http://
http://
http://
What's your diversity make-up? *
Tell us about your personal experience
What's your expertise? *
Please list up to 3 topics that you can speak about from your professional experience
Please list prior speaking engagements, or the details of someone who will vouch for you here (Name, Relationship, Email)
Link to where I can steal your photo from here
http://
The information that I have provided here is truthful and I understand that it will be made public *