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Please provide all information as you would like it to appear in promotional materials. Please do not type any quotes or apostrophes. A valid email is required to confirm your acceptance and to notify you of any changes and/or updates. Technosium respects your privacy and will not release your email address to third party without your permission. Incomplete forms will not be accepted.

* must fill fields
Session Title :    *
Name the track that would be most appropriate for your session:
   *
Name your second choice for the track:
   *
*  Session Abstract:
     (Please write less than 75 words)
*  Justification why your session is relevant:
     (Please write less than 200 words)
*  Is this session:
Technical
Business
If Technical please specify level:
Basic
Intermediate
Advanced
List all the keywords appropriate for your session:
     
*  Session Role:
Individual Speaker
Co-Speaker (Up to 2 speakers per session)
Moderator
Panelist
     
Salutation : Dr. Mr. Mrs. Ms.   *
First Name :    *
Last Name :    *
Company :    *
Company URL/
Website address
:    *
Job Title :    *
Address 1 :    *
Address 2 :
City :    *
State :    *
Postal Code :    *
Country :    *
Email Address :    *
Secondary Email Address :
Telephone
(including country code)
:
Mobile Telephone
(including country code)
:
Fax Number :
     
*  Speaker Biography/CV:
     (Please write less than 100 words)
     
*  Does the proposed participant have professional speaking experience?
Yes No
*  Please list all the conferences and dates where you have spoken in the last 2 years?
     
*  Will the proposed participant be presenting at any other event 30 days prior to this conference?
     Please identify the event and title of the presentation.
     

Please note that we welcome all submissions from you. However Technosium and its affiliates reserve the sole right to accept only those proposals deemed most suitable for the program. As such, we will be able to provide the status of your submission only if it has been selected. At this moment we will not be able to individually reply to every submission that has not been selected. While Technosium cannot guarantee you will be selected, we will however include your name and submission in our master database as potential speaker and will contact you when a suitable opportunity arises. We sincerely thank you for your continued interest in Technosium.

As a speaker for Technosium as well as its parent company, affiliates, successors and assigns (here after referred as Organizers), I hereby agree to give my full and complete consent to duplicate, record, and distribute my contributed content via all types of electronic and print communications and I hereby discharge and acquit Technosium from any and all claims, demands or causes of action that I may hereafter have against the organizers whether for libel or violation of privacy or anything else by reason of recording, duplicating and distribution of my presentation(s) or the material(s) that I delivered to this conference in any form. However this release in no way inhibits me from using my own materials in any manner I so desire.

     
*  Please select one:
I agree to the above terms of this release agreement
I DO NOT agree with the above terms of this agreement
     
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