Speaker Application

Thank you for your interest in speaking at the Retail Customer Experience Executive Summit. Please take a few minutes and tell us a bit about yourself by filling out the form below.


First Name
 *
Last Name
 *
Job Title
 *
Company
 *
Phone Number
 *
Email Address
 *
 
On what topic would you like to speak at our event?
 *
 
Describe your qualifications to speak on this topic:
 *
 
We want to learn more about your professional background and see you in action as a speaker. Please provide links to: (1) LinkedIn profile (2) Twitter page (3) videos (4) other websites
 
List any publications you have authored:
 
Provide at least two references from previous speaking engagements:
Do not enter anything in this field:

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EARLY REGISTRATION SPECIAL
SAVE $200

Register by May 31, 2012


SEATING IS LIMITED...
Qualified attendees only.

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Retail Customer Experience Executive Summit | 13100 Eastpoint Park Blvd | Louisville, KY 40223 | Phone: 877-441-7545