Full Name *

What is your email adress? *

Have you a JCCFQ's valide membership? *

What is your field of expertise? (tick all that apply) *

What is your current job? *

What languages do you speak fluently? *

What languages do you write? *

What type of activities are you interested in participating in? *

Are you interested in participating in interviews related to your field of expertise? *

Have you ever spoken in front of an audience? If so in what context? *

Please include a brief biography of yourself (max 150 words) *

Please insert your LinkedIn profile link *

For the JCCFQ's Speakers Directory, we would need a photo of you. Please send it to the following address: allo@jccfq.com *