CAEP 2020 Speaker Information Request Form

Speaker Information & Bio

We are currently crafting the preliminary program and require information regarding your presentation which will be used for accreditation and marketing purposes. Please submit this form no later than February 28, 2020.

You may exit any time and return at a later date using the link in your email to complete the required information. The system will load directly to where you exited. Use the “previous” button if you would like to review previously entered information.

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* 1. Title:

Dr.

Ms.

Mr.

Other (please specify)

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* 2. Speaker first name:

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* 3. Speaker last name:

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* 4. Email:

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* 5. Telephone number:

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* 6. City:

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* 7. Province:

NWT

Outside of Canada (please specify):

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* 8. Admin contact (name and email):

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* 9. Short (3 line) biography:

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* 10. Head shot - Please rename your file using the Last Name_First Name format.

Head shots will be used for marketing purposes, including on the website and social media.

JPEG, JPG, PNG file types only.

Choose File