Exit this survey IDEA eBiz Forum 2016 Speaker Application Question Title Please provide the following contact information (complete all fields): Name: Job Title: Company: Mailing Address: City: State/Province: ZIP/Postal Code: Country: Email Address: Phone Number: Question Title Please provide the following emergency contact information (complete all fields): Emergency Contact Name: Relationship: Phone Number: Question Title Date(s) available to present: 5/25 - Wednesday 5/26 - Thursday 5/27 - Friday Available all days Question Title General topic(s): Question Title Target audience(s): Question Title Please provide an abstract of your proposed session or sessions (description and objectives): Question Title Please be advised that photographs and video will be taken at the event for use by IDEA in various media including, but not limited to: the IDEA website, press releases, marketing materials, and publications. I unders and that applying to speak at this event means I give consent for IDEA to photograph, film and use my image and likeness.By providing my electronic signature below, I am indicating that I understand that applying to speak for this event also means that I give consent for IDEA to distribute my speaker presentation to all eBiz Forum attendees and also make it available to download on the eBiz Forum website. Submit