WCG MAGI Clinical Research Conference Call for Speakers Question Title * 1. First Name Question Title * 2. Last Name Question Title * 3. Credentials Question Title * 4. Current Title Question Title * 5. Current Organization Question Title * 6. Work Email Question Title * 7. Personal Email Question Title * 8. Work Phone Question Title * 9. Mobile Phone Question Title * 10. Bio Question Title * 11. LinkedIn Profile Question Title * 12. What topic or topics are you qualified and interested in speaking about? Please be as specific as possible (e.g., not “contracts”) Question Title * 13. By submitting this form you are confirming that:1 - You would be available and willing to travel to Philadelphia for the WCG MAGI conference, if you are speaking2 - You are or will be fully-vaccinated against COVID-19 (required for all attendees)I understand (Type Name to Agree) Done