Speaker Information Survey

Tips: Except for your private information (which will be marked as “PI”), other information we collect will be sometimes used for promotion activity. If there is anything you fill out that is not suitable for public exhibition, please tell us.

Name

    ____________

Field

Technology
Education
Entertainment
Design
Business
Science
Social Issues
Other

Nationality

    ____________

Date of Birth(XX/XX/XX, PI )

    ____________

Address ( PI )

    ____________

Contact ( PI )

Phone:    ____________
E-mail:    ____________

Social Media Link (Optional)

    ____________

What are your passionate about in your life?

E. G., Your work, your social activity, your life philosophy…

    ____________

Your Speech Title & Content Introduction

If you haven’t decided, please write N/A .

    ____________

Remark

What do we need to know about you that we didn’t ask? Do you have any other questions or requirements? If not, please write N/A.

    ____________

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