Organisation Name

Speaker Name

First Name

Last Name

Speaker Email Address

Speaker Phone Number

Session Type (subject to availability with preference given to sponsor companies)

KEY NOTE: Audience of 300 + students. 15 minute sessions.

SUPER WORKSHOP/PRESENTATION: Audience of 100 + students. 45 minute presentation or demonstration.

WORKSHOPS: Audience of 30 students. 45 minute interactive sessions.

Topic and abstract of your presentation

Back up speaker if you are not able to come on the day. Please provide name and contact details.

Are you willing to repeat your session on the day if slots are available

Yes - only 1 repeat

Yes - as many as available (maximum 4)

Speaker undertaking

I will provide my Speaker Biography to the Go Girl team ASAP I consent to my image in pictures/videos of the event being property of the Go Girl team . The Go girl team will use the images/videos as appropriate in communications related to the event and VICICT for women I will provide a copy of my final presentation to the Program Committee by Friday 27th July 2018 I am available on the day of the event. 16th August 2018

Please acknowledge your acceptance of the above requirements.