Speaker Bio Data Form

Title
Speaker's Name*
First Last
Job Title
Company
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Please list the best number to reach you at incase of emergency.
Email*
Speaker Bio (brief 2-3 sentences)*
Please include education and professional affiliations/organizations.
Title of Presentation*
Description of Presentation (~25 words)*
Conference Proceedings*
Presentations will be saved as secure PDFs for online viewing only as part of the conference proceedings.
- Yes, you can use my presentation
- No, please do not include as part of the conference proceedings
Co-Presenters (please list if presenting)
We ask that all presenters complee a speaker bio form and register for the event.
Audio/Visual Equipment Requirements A computer and LCD projector will be available for your use. Please bring your presentation on a flash drive. Moderators will collect presentations and pre-load them on the day of the conference.
Please list any additional audio visual equipment that you need