Please fill in your details * First name * Last name * Phone (This will not be shared, this is for onsite health and safety and cases of emergencies) * Email * Job Title * Organisation as you would like it displayed on our website & within our Event guide * Date of Session/ Chairing * Session title(s)Please confirm your session title(s) or chairing Other comments * Upload a clear headshot profile image. Please note this must be a 300dpi colour profile image of yourself. Jpeg only Select Files File uploading Click 'Upload' button to change image/file. Upload Crop Image Width: Height: Lock proportions: Resize Image How we use your data By submitting this form you are registering your interest for one of our events or services your personal data will be processed by us in accordance with our privacy policy, including: (i) sending you updates in relation to the event/service; and (ii) sending you information about other products and services that we believe may be of interest to you. You can read more about our privacy policy here: https://www.nineteengroup.com/privacy-policy If you would like to prevent your personal data being processed in this way, please contact us by email to data@nineteengroup.com to update your preferences. This field is required. Submit