DIAA SPEAKER CONFIRMATION FORM Spam protection, skip this field 2023 DIAA Victorian Conference I May 4 & 5 I Atrium Flemington Racecourse To confirm this speaking engagement, please complete and sign the form below by Friday, 14th April 2023 I agree to participate in the 2023 DIAA Victorian Conference at Atrium Flemington Racecourse on May Thursday, 4 / Friday, May 5. All information relating to my session is as follows: Presenter Name Presenter Company Presenter Position Presenter Phone Number/s Presenter Email Presenter Address Conference Session Title(s) Session Description(s) (brief- two sentences max.) A/V Requirements (optional) The Conference audio visual set up will include the following items: • Projector and screens, with presentation clicker • Stage monitor so you can view your presentation • Lectern with microphone If you would prefer an alternative microphone please select from the choices in the next question. Should your presentation require something outside of this, please advise in the space above and we will endeavor to accommodate your needs. All presentations MUST be submitted in Widescreen (16:9 ratio) in Microsoft PowerPoint format to katherine@onthetableevents.com.au by Friday, April 21. Should your presentation require something outside of the above audio visual provision then please advise here and we will endeavor to accommodate your needs. Question Time - If time permits are you comfortable to take questions from audience? Yes No As a presenter, I agree to the following: The above information is used for all conference marketing activities. Where required, I permit the DIAA to edit my session description for clarity and length. Giving DIAA permission to use photographs, videos, direct quotes, etc. for a variety of purposes including, but not limited to, publications, promotional collateral, social media and the DIAA website. Permitting DIAA to distribute PowerPoint slides to all delegates post Conference. No substantive changes in content or presenters are made without prior written approval from DIAA. In the event the original presenter is unable to attend, a substitute presenter of equal expertise will be provided, and DIAA will be notified immediately. By signing this form and based on mutual considerations, I hereby understand and agree to the above terms and conditions. Signature I agree that my typed name below will be as valid as a handwritten signature to the extent allowed by local law Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month January February March April May June July August September October November December Year 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035 2036 2037 2038 2039 2040 2041 2042 2043 Save draft
