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Speaker Request
First Name
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Last Name
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Phone
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Email
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Provide event name and brief description.
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What are the event date(s)?
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Where is the event taking place?
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What is the specific date and time of the requested speaking slot?
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Which 23andMe representative/executive are you requesting?
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If the requested speaker is unavailable, is there another 23andMe representative that you would consider in his/her place?
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Tell us more about the audience. What is the expected attendance? What is the audience make-up (e.g. primary care physicians, media, tech, executives)?
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Will media/reporters be in attendance? If yes, please share a brief list of expected media
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Provide a brief summary of the topic(s) or areas of interest you’d like 23andMe to cover.
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What is the format of the session?
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Keynote
Keynote
Panel
Panel
Q&A/fireside chat
Q&A/fireside chat
Other
Other
Is a formal presentation required? Note: in certain circumstances, we are unable to provide the slides/presentation in advance.
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Yes
Yes
No
No
What is the total speaking time?
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If this is a panel discussion, provide names and titles of other panel participants. If not confirmed, include a list of those invited.
Will there be an opportunity for audience Q&A? If yes, indicate the duration.
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What is the room size? How many people can it accommodate?
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Please detail A/V provided.
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If applicable, what is the slide ratio required?