Call for Speakers

If you wish to make a presentation proposal, please complete and submit the following form in its entirety, as only complete forms will be considered. It is our policy to review all completed applications and file them for consideration on appropriate programs. Please note that we are particularly interested in receiving proposals from pharmaceutical or biotechnology companies.

First Name: *
Last Name: *
Company Name: *
Department: *
Title: *
Key Area of Expertise: *
Company Website Address:
Mailing Address 1: *
Mailing Address 2:
City: *
State/Province: *
Zip Code: *
Country: *
Speaker's Telephone:
Speaker's E-mail Address:


Contact's First Name: *
Contact's Last Name: *
Contact's Telephone: *
Contact's Email Address: *

Describe the subject matter the proposed speaker will address and how it relates to the theme of the conference: * What qualifies the speaker or their company to make this presentation? * Please provide speaker bio in space provided, or forward under separate cover to conferences@cancom.com. Subject line: (company name) speaker proposal.*

* Denotes a required field

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