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Speaker Registration Form

Expression of Interest to apply to speak at the public event

A. PLEASE NOMINATE YOUR INTEREST IN THE PROJECT:


B. PLEASE NOMINATE HOW LONG YOU WOULD LIKE TO SPEAK FOR:

(Please note to allow as many people as possible to speak, requests over five minutes may not be able to be granted)



(Please note the Commission reserves the right to verify with the organisation body or group)

C. ADDITIONAL MATERIAL

D. PRESENTING TO THE PANEL


By using the speaker registration form I accept that I have read, understood and agree to the following terms and conditions:
Any information given to us may be published on our website, unless explicitly stated otherwise. All personal contact details (other than names) will be removed before online publication, but may be provided to relevant government departments. Before submitting the form, please read our Privacy Statement at www.ipcn.nsw.gov.au or call us on (02) 9383 2100.