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Complete the requested information below and email your video demo to Allyson Knott (aknott@iianc.com) by March 1. Incomplete applications (i.e. you submit the information below but do not send a video demo) will not be considered.

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* 1. Company Name:

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* 2. Main Contact Name:

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* 3. Main Contact Email: 

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* 4. Company Website:

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* 5. Provide a written description of the product, service, market, etc. that you want to pitch to InsurEXPO19 attendees:

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* 6. List any of your company's social media handles/channels: 

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