FIA Speakers Bureau Application

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* 1. Name (First and Last)

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* 2. Affiliation (Company or Self)

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* 3. Phone Number:

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* 4. Email Address:

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* 5. Years of experience in the industry?

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* 6. Short Bio (Paragraph)

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* 7. Headshot/Photo

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* 8. Subjects of Expertise

Metallurgy/Materials

Automation and Robotics

Maintenance

Lubrication

Equipment/Technology

Operations/Leadership

Simulation

Heating and/or Heat Treatment

Other (please specify)

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* 9. Are you willing to travel to various plants/facilities to present?

Yes

FIA Speakers Bureau Application

Question Title

* 1. Name (First and Last)

Question Title

* 2. Affiliation (Company or Self)

Question Title

* 3. Phone Number:

Question Title

* 4. Email Address:

Question Title

* 5. Years of experience in the industry?

Question Title

* 6. Short Bio (Paragraph)

Question Title

* 7. Headshot/Photo

Question Title

* 8. Subjects of Expertise

Question Title

* 9. Are you willing to travel to various plants/facilities to present?

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* 10. Additional comments: