Speaker Information

Name*
First Last
Designation (i.e. PhD, MBA, MD)
Title*
Organization/Affiliation*
Email Address*
Alternate Email Address (i.e. assistant)
Mobile Phone
By providing your mobile phone number, you agree to receive text communication related to the event.
Working Presentation Title
Presentation Abstract (If applicable)
Please upload a headshot, a short bio (to be used on BreakthroughSymposium.com, the BTS2020 program and other promotional materials), and your full bio/CV.
Headshot (file formats accepted: JPEG, PNG)
Accepted file types: jpg, jpeg, png, gif, Max. file size: 100 MB.
SHORT BIO (300 word limit)
FULL BIO/CV
Max. file size: 100 MB.
We are looking forward to hosting you in Fargo! In an effort to arrange the conference speaker line up, please share your travel plans/availability as you know it now.
- I am able to attend the full conference September 28 - 30, 2020. I can speak either that Tuesday or Wednesday.
- I am only available to speak on Tuesday, September 29, 2020.
- I am only available to speak on Wednesday, September 30, 2020
We would like to announce your participation as a speaker for Breakthrough Symposium 2020. Do you approve?
- Yes; please send to me for review and approval before distribution.
- Yes; not necessary for me to review before distribution.
- No
WE WOULD LIKE TO SHARE APPROPRIATE CONTENT ABOUT YOU OR YOUR WORK AS DISCOVERED THROUGH ROUTINE GOOGLE SEARCHES (ANY PUBLISHED INTERVIEWS, PAPERS, NEWS ABOUT YOUR RESEARCH). Aldevron will share this content via our social media channels to amplify your participation and to generate interest in attending Breakthrough Symposium 2020. DO YOU APPROVE?
- Yes
- No
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