"*" indicates required fields This field is hidden when viewing the formSubmissionDateParticipation formatSelect option(s)* Speaker Panelist Moderator Presentation Type* Commercial presentation Non-commercial presentation Participation in the panel Not applicable Commercial organisation Price: Includes 2 admissions to the Forum (speaker + delegate) £1,300 GBP + 20% VATSpeaker’s profileName* First Last Job title*Company*Email* PhoneCountry code + phone numberSpeaker’s biographyUp 1500 characters Speaker’s recent photo*Accepted file types: pdf, jpg, jpeg, png, Max. file size: 32 MB.Please attach or email eu@minexforum.com speaker’s recent colour photo in high resolution (minimum size 150 kb and max file size 5 MB). Add DelegateNumber of delegates*1 delegate (not a speaker)2 delegates3 delegatesFree Price: Business rate (20% VAT included) Price: Business rate (195 + 20% VAT)Business rate (20% VAT included) Price: Business rate (390 + 20% VAT)Total Delegate 1Delegate 2 Name Prefix Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. First Last Delegate 2 Job TitleDelegate 1 CompanyDelegate 1 Email* Delegate 1 PhoneDelegate 2Delegate 1 Name Prefix Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. First Last Delegate 1 Job TitleDelegate 2 CompanyDelegate 2 Email* Delegate 2 PhoneDelegate 3Delegate 3 Name Prefix Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. First Last Delegate 3 Job TitleDelegate 3 CompanyDelegate 3 Email* Delegate 3 PhonePresentation summaryPresentation title*Short synopsis ~150 wordsCompany ProfileInformation about the company to be published in the conference mediaCompany nameBrief information about the exhibitor company (up to 150 words)Company `s logo (300x300px)Accepted file types: jpg, gif, png, pdf, Max. file size: 32 MB.Send the company logo to info@smartindustry.live or attach it to this form using the "Choose File" button above.Materials in PDF (include hyperlink to zip file)Link to video presentation (include hyperlink to zip file)Link to video presentation (include hyperlink to zip file)Link to the corporate websiteLink to FacebookLink to LinkedInLink to SkypeInstagramLink to YoutubeSocial NetworksLinkedInFacebookTwitterYoutubeAlternative Contact (Assistant)NameEmail PhoneTime required*10 minutes15 minutesMoreModerator or PanellistTerms & Conditions* I have read and agree with "Privacy Policy" and "Terms & Conditions". Newsletter I agree to subscribe to newsletters and event invitations from MINEX Forum Your Comments, e.g. dietary restrictionsOptionalThis field is hidden when viewing the formPostIDPayment InformationSelect Payment Method* Stripe Bank Transfer TotalTotal InstagramThis field is for validation purposes and should be left unchanged.