Speaker & Panelist Information Form

Personal Information

Full Name *

Title / Position *

Organization / Company *

City *

Country

Email Address *

Phone *

Participation Type *Keynote SpeakerPanelistModeratorTechnical Presenter ( CITAC, NPA)

Session Title / Topic *

Short Biography (150–200 words) *

LinkedIn Profile (optional)

Upload High-Resolution Headshot *(JPG or PNG – minimum 5MB recommended)

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Permission to Use Photo and Bio for Conference Promotion *YesNO

Will you be attending the Gala & Awards Night? *YesNO

Upload Presentation Slides

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Agreement *

I confirm that the information provided is accurate and may be used for official conference materials.

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