2017 Speaker Nomination Form

Please submit nominations for speakers for this year's Women in Technology Conference who can offer valuable insight on topics that matter to women in tech, have extensive public speaking experience and are passionate about supporting women in tech.

Please Note: Speaking opportunities are limited. Response deadline is April 15, 2017.

Nominee First Name
Your answer
Nominee Last Name
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Nominee Company
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Nominee Title
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Nominee Email
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Nominee Phone
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What is the Speaker's topic of interest and/or expertise? What topics has the Speaker presented or is comfortable with discussing?
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Please provide a link to the nominee's LinkedIn profile.
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Please provide a short bio or link to their bio.
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Link to video clips of Speaker's prior speaking engagements (highly encouraged).
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Company or personal website
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Does the Speaker have a background in tech? How so?
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Share any experience with spearheading initiatives that contribute to increasing visibility for women and diversity in tech.
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Why should we choose this Speaker for the CTA Women in Technology Conference 2017? This is a chance to shine! Highlight all the areas that may be of value to this conference.
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If you are not self-nominating, please provide your contact information in case the committee needs additional information.
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