Presenter Application

PRESENTING

* Indicates required field

Name *

First

Last

Addressing (Mr, Ms, Mrs, _) *

Email *

Education *

Organization *

Phone Number *

Postal Address *

Attach your 500 x 500 pix head photo *

Max file size: 20MB

A head to hip photo 1000 x 1000 pix *

Max file size: 20MB

Linked in *

Your Twitter *

Your Instagram *

Your Facebook *

Your Youtube *

Presentation Type *

2 Hour Keynote 1 Hour Presentation

Presentation Title *

Abstract (500 words) *

How is it brand new? *

Target Audience *

List five learning objectives for your presentation. *

Subject Relevance *

Relevance to Ayurveda *

Relevance to Clinical Practice *

How does your presentation relates to Ayurveda and its principles *

Your professional biography: *

Educational degrees, education centres and experience *

Previous professional presentations/appearances: *

Publications: *

Do you have any special requirements for your presentation? *

Do you need any help to promote the conference and your presentation? *

YES NO

Any additional comments: *

I agree to adhere to the guidelines and requirements set forth by the conference organizers. *

YES

Submit