CogX Events - Speaker Application
Complete this form if you would like to participate as a keynote speaker or panellist at any of our CogX events.

Please fill in this form as completely and accurately as possible. All required fields are marked with *

First name
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Last name
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Job title / role
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Organisation
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Email address
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Personal phone number
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Office phone number
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Assistant / PA's email address
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Assistant / PA's phone number
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At which CogX event would you like to speak?
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What kind of speaking opportunity are you looking for?
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Brief speaker bio (max 100 words)
Your answer
Brief organisation / company description (max 50 words)
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Organisation / company website url
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If you were to name your session "Impact of AI on ___” what would it be called?
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What are a some of the discussion points you'd like to cover?
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Spoken publicly before? If so, where?
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Please provide link to video/audio speaking footage
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Please provide any links/urls to articles/web pages about yourself
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