Request edit access
BRS Speaker Application Cannes
Thank you for submitting your speaker application. We're excited to review your form and hope to have you join us as a panelist at the Based Rollup Summit. in Cannes 2025.
Sign in to Google to save your progress. Learn more
First Name *
Last Name *
Email *
Company *
Your Role *
Website *
Speaker Twitter *
Speaker Telegram *
Talk format *
Focus of keynote/panel contribution
Would you be interested in becoming a sponsor for this event?
Sponsors are being prioritised for keynote slots at this time
Clear selection
Please note that as a speaker, you will be included in event photography and video recordings used for promotional purposes related to your presentation and the summit. By participating, you acknowledge and consent to the use of your likeness in these materials. *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of taikochain.

Does this form look suspicious? Report