Smart Cities Innovation Accelerator at Toronto

Please fill out the information below to apply. All fields marked * are required.  Information will be used directly for event program and logistics updates, so please do fill our all the required boxes!

Registration Day
What day are you registering for?

Question Title

* 1. What day are you registering for?

USER DETAILS
First Name

Question Title

* 2. First Name

Last Name

Question Title

* 3. Last Name

Biography

Please enter 50-150 word bio of yourself. This will appear *verbatim* in the program.

Question Title

* 4. Biography

Please enter 50-150 word bio of yourself. This will appear *verbatim* in the program.

Email - This will be used to contact you for updates of the event.

Question Title

* 5. Email - This will be used to contact you for updates of the event.

Title

Question Title

* 6. Title

Organization

Question Title

* 7. Organization

Street

Question Title

* 8. Street

City

Question Title

* 9. City

State

Question Title

* 10. State

Zip Code

Question Title

* 11. Zip Code

Country

Question Title

* 12. Country

Phone

Question Title

* 13. Phone

Dietary restrictions or allergies

Question Title

* 14. Dietary restrictions or allergies

Headshot for printed program and photo roster

Question Title

* 15. Headshot for printed program and photo roster

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.
Choose File
No file chosen
APPLICATION FOR TRAVEL SUPPORT
Travel support for up to two city officials is available while funding lasts. Travel support is paid and booked directly by the event and includes: coach airfare and two nights hotel. All other travel expenses are the responsibility of the traveler/city. (Travelers outside of N. America - travel support is only provided for hotel, but will include 3 nights).

Travel support is provided by the event organizer, The Innovators Forum, LLC. Please check with your city to see if they require any additional information for you to accept travel support.

If your city can support your travel, please do not request travel support. We may not be able to support all applicants.

All travel must be booked by August 18th - no late travel reservations will be permitted.
I am requesting travel support because my city/organization is not able to support my travel. We ask those cities who can support travel to please do so, as we will not be able to support all requests. Having your city support your travel will allow other cities to attend, who do not have the means for travel support.

Question Title

* 16. I am requesting travel support because my city/organization is not able to support my travel. We ask those cities who can support travel to please do so, as we will not be able to support all requests. Having your city support your travel will allow other cities to attend, who do not have the means for travel support.

I am employed by the city, or my employer is wholly owned by the city and I wish to apply for travel support.

Question Title

* 17. I am employed by the city, or my employer is wholly owned by the city and I wish to apply for travel support.

Name of second person attending from your city (they should register separately also). If three are attending, simply enter one name to confirm eligibility.

Question Title

* 18. Name of second person attending from your city (they should register separately also). If three are attending, simply enter one name to confirm eligibility.

Name as it appears on your government ID (for travel purposes).

Question Title

* 19. Name as it appears on your government ID (for travel purposes).

In the case that I decide or am unable to attend, I agree to reimburse the event organization for any non-refundable travel expenses incurred.

Question Title

* 20. In the case that I decide or am unable to attend, I agree to reimburse the event organization for any non-refundable travel expenses incurred.

Are there any special travel requirements we should know about? Seating will be chosen by you through the carrier directly after booking the flight. This will allow you to select and upgrade your seat if you choose. We typically book the lowest coach airfare with a maximum of 1 layover. If several routes are similarly priced, we will provide the traveler with options.

Question Title

* 21. Are there any special travel requirements we should know about? Seating will be chosen by you through the carrier directly after booking the flight. This will allow you to select and upgrade your seat if you choose. We typically book the lowest coach airfare with a maximum of 1 layover. If several routes are similarly priced, we will provide the traveler with options.

Airport traveling from (three letter code).

Question Title

* 22. Airport traveling from (three letter code).

Date of birth (will be held confidential, but required to book flights).

Question Title

* 23. Date of birth (will be held confidential, but required to book flights).

Date / Time
Male or Female (required to book flights)

Question Title

* 24. Male or Female (required to book flights)

ADMIN DETAILS
We will be happy to work directly with your admin on logistics and even updates if you provide their information. 
Admin's Name

Question Title

* 25. Admin's Name

Admin's Title

Question Title

* 26. Admin's Title

Admin's Email

Question Title

* 27. Admin's Email

Admin's Phone

Question Title

* 28. Admin's Phone

MEDIA CONTACT INFORMATION
As our events engage senior leaders, we are sometimes contacted by press who are interested in contacting attendees for their perspective and thoughts on the event topic. We keep your contact information confidential and do not share it with the media; however, if you would like to be contacted, you may opt-in by typing YES in this box. Leaving it blank or typing NO will let us know not to share your information.
Share Contact?

Question Title

* 29. Share Contact?

LINKS (PR for you/your city - optional)
These will be used on the dissemination website as resources for other attendees and the general public.
Link 1

Please enter a link to your website or other online collateral.

Question Title

* 30. Link 1

Please enter a link to your website or other online collateral.

Link 2

Please enter a link to your website or other online collateral.

Question Title

* 31. Link 2

Please enter a link to your website or other online collateral.

YouTube/Vimeo Link 1

Please enter a link to any videos you would like to share with other participants.

Question Title

* 32. YouTube/Vimeo Link 1

Please enter a link to any videos you would like to share with other participants.

YouTube/Vimeo Link 2

Please enter a link to any videos you would like to share with other participants.

Question Title

* 33. YouTube/Vimeo Link 2

Please enter a link to any videos you would like to share with other participants.

Thank you for completing the application. Please click the DONE button below. We will review your application and let you know our decision soon.

T