Submission form for contributors details 2015

This form is intended for contributors of PCDI activities.

Only your name, affiliation, email, biosketch and picture will be published.
Your mobile number and other details are used for organisational purposes only.

Your details

First Name (*)
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Surname (*)
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Email (*)
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Mobile No (*)
Please enter your phone number. Omit all spaces and dashes
 
Position (*)
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Affiliation (*)
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Contribution (*)
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Photo & Biosketch

Photo upload (*)
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Please rename file to refer to your name e.g. Janssen_M.jpg

Maximum length of biosketch:
120 words [forum panellist/speaker/networker], 100 words [trainer]

Biosketch (*)
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Arrival details

I will arrive on (*)
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around
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Taxi
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Questions or remarks
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Confirmation

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