2017 Tech Talk Interest Form Thank you for your interest in hosting a 2017 Tech Talk! Please complete the short form below and we will be in touch with you shortly. Please contact Jacqui Logan, jacqui.logan@technologycouncil.com with any questions. Your Information (Please submit the information for the person completing this form) First Name * Last Name * Your email * Proposed Speaker Information (Please submit the information for the primary person who would give the Tech Talk) First Name * Last Name * Proposed speaker email * Title of proposed Tech Talk * Abstract of proposed Tech Talk * Brief bio of primary Tech Talk speaker * Headshot of primary Tech Talk speaker * Please select the date you are most interested in hosting * April 13, 2017 May 11, 2017 June 8, 2017 July 6, 2017 August 17, 2017 September 14, 2017 October 12, 2017 November 9, 2017 December 14, 2017 Flexible/ Could do multiple dates Company logo for website and marketing materials * Any additional comments you want to share? .