z- SampleCon 2022 Call For Speakers Submission Form SampleCon 2022 Call For Speakers Submission Form Contact Information First Name * First Last Name * Last Job Title * Company * Email * Phone * Type of Submission Session Join a Panel/Debate Moderate a Roundtable Discussion/Collaboration Lab Speaker/Panel Questions Please tell us what category your topic covers (you may select more than one): * Innovation Methodology End Client Use Case Proposed Session Title: Proposed Session Abstract (max 100 words): [Max 100 words] Session Objectives: Please provide us with 3-4 bullet points describing the key takeaway for our attendees Why is this topic important for SampleCon attendees to learn from? Describe the format of your session? Single Speaker Panel Interview Collaborative Group Discussion Panel/Debate Information Please Share with us the topic(s) you are interested in joining a panel on at SampleCon: Please tell us about the speaker’s opinions/solutions/thoughts and what would they bring to a panel on the selected topic: * (max 150 words) What does the speaker hope to achieve by participating in a panel and/or debate at SampleCon? * (max 100 words) Has this speaker spoken at other conferences on this topic and/or published written blogs/articles etc on the topic? Yes No (if yes, please include links if available) Please Include Links if Possible Moderate a Roundtable Discussion Questions Please tell us about the speaker’s opinions/solutions/thoughts and what they would bring as a moderator on this topic * (max 150 words) What does the speaker hope to achieve by participating as a moderator at SampleCon? * (max 100 words) Has this speaker spoken at other conferences on this topic and/or published written blogs/articles etc on the topic? Yes No (if yes, please include links if available) Please Include Links if Possible Speaker Information: Please fill out the information below for EACH speaker you are submitting: Speaker 1: First Name * First Last Name * Last Company * Job Title * Email * Phone * Bio * [100 Words Max] Headshot * Drop a file here or click to upload Choose File Maximum upload size: 3MB Spoken at a prior SampleCon? * Yes No Speaker 2: First Name * First Last Name * Last Company * Job Title * Email * Phone * Bio * [100 Words Max] Headshot * Drop a file here or click to upload Choose File Maximum upload size: 3MB Spoken at a prior SampleCon? * Yes No Speaker 3 First Name * First Last Name * Last Company * Job Title * Email * Phone * Bio * [100 Words Max] Headshot * Drop a file here or click to upload Choose File Maximum upload size: 3MB Spoken at a prior SampleCon? * Yes No Speaker 4: First Name * First Last Name * Last Company * Job Title * Email * Phone * Bio * [100 Words Max] Headshot * Drop a file here or click to upload Choose File Maximum upload size: 3MB Spoken at a prior SampleCon? * Yes No Speaker 5: First Name * First Last Name * Last Company * Job Title * Email * Phone * Bio * [100 Words Max] Headshot * Drop a file here or click to upload Choose File Maximum upload size: 3MB Spoken at a prior SampleCon? * Yes No If you are human, leave this field blank. Submit
