Speaker Information

Thank You For Joining CityAge as a Speaker

Please complete the below fields as best you can.
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Speaker Form Unified

PERSONAL INFORMATION

First Name

Last Name

Preferred Pronouns (optional):

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CONTACT INFORMATION

Mobile Number

PROFESSIONAL DETAILS

Company/Organization

Job Title/Position

Linkedin URL

Short Bio (500 words max)

Link for longer bio (if needed):

PRESENTATION INFORMATION

Event Title and Date

Presentation Title/Topic:

Any articles or interviews you wish to share with the CA network? (URL):

Technical Requirements for Your Presentation:

How confortable are you presenting in Zoom in scale to 1 to 5

ADDITIONAL INFORMATION

Dietary Restrictions (if applicable):

If you are attending a live event, please indicate your dietary preference

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Speaker Information

Thank You For Joining CityAge as a Speaker

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