Keynote Speaker Application Form
Submitter Information
Name:
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Title:
(PhD/Dr/…)
Affiliation:
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Position:
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Address:
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City
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Prov./State
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Country
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Phone number
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Fax.
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e-mail
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Web page:
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Postal Code Please type the postal code
Keynote Presentation Information
Keynote Title Proposal:
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Abstract (max 200 words):
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Keywords:
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Theoretical background / Research problem (max. 500 words):
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Approach / Research methodology:
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Results / Main findings
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Contributions / Original aspects
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Link with the conference theme
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Short biography
Research expertise domain:
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List of the most relevant publications/scientific results (up to 10)
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Signature
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Date
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