Speakers' Corner Request Form


* Required Fields

Your personal information

* First name:
* Last name:
* Organization:
* Phone number:
Fax:
* Email:
* Name of Event:
* Theme of Event:
* Date:
* Location:
* Time:
* Event Type:
* Event Audience:
* Speaking Category:
* Topic or Subject Area to be addressed by speaker:
Additional Notes:
 

 

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Your email address and other information provided by you on this form will be used only to send events reminders and program/promotions information. Nortel Government Solutions will not use your personal information for any other purpose without your permission, and we will never sell or give your email address to anyone else. Every email you receive from us will contain simple instructions for removing yourself from the list or changing your profile.

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