Speaker Request

First Name *

Last Name *

Phone *

Email *

Provide event name and brief description. *

What are the event date(s)? *

Where is the event taking place? *

What is the specific date and time of the requested speaking slot? *

Which 23andMe representative/executive are you requesting? *

If the requested speaker is unavailable, is there another 23andMe representative that you would consider in his/her place? *

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)? *

Will media/reporters be in attendance? If yes, please share a brief list of expected media *

Provide a brief summary of the topic(s) or areas of interest you’d like 23andMe to cover. *

What is the format of the session? *

Keynote

Panel

Q&A/fireside chat

Other

Is a formal presentation required? Note: in certain circumstances, we are unable to provide the slides/presentation in advance. *

Yes

What is the total speaking time? *

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. *

What is the room size? How many people can it accommodate? *

Please detail A/V provided. *

If applicable, what is the slide ratio required?