2012 Payments Summit Presentation and Speaker Proposal Form

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Proposed speakers and contact persons will be contacted by email on or about February 17 if they have been selected or are still being considered for a speaker position. Speakers who are selected will receive a complimentary full conference registration for the event, however there are no other speaker fees or reimbursements for travel provided for speakers.

Questions? Contact Randy Vanderhoof at events@smartcardalliance.org.

Topic Category: *

Presentation Topic Title *

Presentation Description (approximately 75 words) *

Proposed Speaker Info

Name: *

Job Title: *

Organization: *

Street Address: *

City: *

State: *

Zipcode: *

Phone: *

Fax:

Email: *

Contact Person

Only enter information if contact person and/or contact information differs from Speaker Info above.

Name:

Job Title:

Organization:

Phone:

Fax:

Email:

Submit

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