CTIA Super Mobility 2016 Call for Speakers Please complete this form to be considered for speaking opportunities at CTIA Super Mobility 2016, September 7-9, 2016, Sands Expo, Las Vegas. Speaking platforms include the Mobile Intelligence Conference, Enterprise & IT Stage on the exhibit floor and Mobile CE stage on the exhibit floor. DEADLINE: WEDNESDAY, JANUARY 20, 2016, 11:59 PM ET Please indicate your role: * Speaker/Applicant PR/Marketing Contact Admin/Coordinator PR/Marketing/Admin/Coordinator Name * First Last PR/Marketing/Admin/Coordinator Job Title * PR/Marketing/Admin/Coordinator Company * PR/Marketing/Admin/Coordinator Address * Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country PR/Marketing/Admin/Coordinator Email *
PR/Marketing/Admin/Coordinator Phone * Speaker Name * First Last Speaker Job Title * Speaker Company * Speaker Address * Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country Speaker Email [For internal and show management use only] * Speaker Phone * Speaker Gender Female Male Prefer Not to Answer Speaker Age 18-24 25-34 35-44
45-54 55-64 65 or Above Prefer Not to Answer Company's Primary Business * Other Principal Business (please specify): Company Description (500 characters w/ spaces max) * Maximum Allowed: 550 characters. Currently Used: 0 characters. Company Website * Please upload your company logo in EPS format (will only be used to promote confirmed speakers): Choose File No file chosen Please check the box below to grant CTIA permission to use the uploaded logo to promote confirmed speakers. Yes, if speaker is confirmed, CTIA has permission to use the uploaded logo for promotion. Tell us about the speaker's expertise: Speaker's Title Classification * C-Level (CXOs, Chairman, President, Owner, Partner, Founder etc.) Executive & Senior Management (SVP, VP, GM, Director) Specialist/Technical Manager/Account Executive Other (Please specify)
Speaker's Job Function * Bus Dev/Sales Buyer/Purchaser Consultant Developer/Programmer/IT Engineering/R&D Finance/Payments/Investment Government/Policy/Regulatory/Legal Marketing/Communications Operations/Logistics/Supply Chain/Business Process Product Management Reporter/Analyst Security/Privacy Strategy & Management Other Please indicate speaker's top 3 areas of expertise (maximum of THREE please). * 5G Technology 5G Use Cases 4G LTE Advanced Technology & Advanced Features Application Development Big Data Analytics, Cloud Connected Life Car/Transportation Connected Life Health, Fitness & Wellness Connected Life Money, Payments, Commerce, Banking Connected Life Smart Home, Smart Appliances Cybersecurity Engineering Cybersecurity Policy Cybersecurity Threat Landscape and Risk Management E-911 Indoor Location Accuracy E-911 New Technologies Enterprise & Business IT
Entrepreneurship Funding, Product Development, etc. Industrial IoT - Connected/Smart Cities Industrial IoT - Smart Grid Industrial IoT - Logistics IoT Policy IoT Privacy IoT Security IoT Use Cases Mobile CE & Devices Mobile Marketing, Advertising & Media Network Resilience Privacy Data De-identification Privacy Engineering Privacy Policy Retail Smart Stores, Retail Environments & Solutions Retail Spotting Product Trends SDN/NFV Small Cells Spectrum Wi-Fi & Unlicensed Spectrum Other (specify below) Is the speaker willing to moderate a session? Yes No Please provide details of the speaker's upcoming or recent speaking engagement(s) at CTIA or other tech event(s). Include the name and date of the event(s) and the topic(s) presented.
Speaker Video If available, please provide a link to a previous speaking engagement. Speaker Photo - please provide a high-res photo (300+ dpi preferred) in JPEG format Choose File No file chosen Please check the box below to grant CTIA permission to use the uploaded photo to promote confirmed speakers. Yes, if speaker is confirmed, CTIA has permission to use the uploaded photo for promotion. Speaker Biography (500 characters w/spaces max) * Maximum Allowed: 620 characters. Currently Used: 0 characters.
CTIA Super Mobility 2016 Call for Speakers Tell us about your proposal/abstract: CTIA is seeking executives to speak on the following tracks. Please indicate your proposal's best fit. * 4G LTE Advanced/5G Cybersecurity IoT Consumer/Connected Life (e.g. connected home, car, health) IoT Industrial (e.g. smart cities, smart grid, etc.) Policy & Regulation Privacy Other (specify below) Please insert speaker's proposal below and be sure to include the following: A list of 3-5 key proposal messages with a one-line description of each Why proposal topic(s) are relevant in 2016 and beyond Anything else CTIA should know that sets this speaker apart from other applicants (1000 characters w/spaces max) * Maximum Allowed: 1100 characters. Currently Used: 0 characters.
Proposal Type * Other Proposal Type (please specify)
CTIA Super Mobility 2016 Speaker Release Form This online release will serve as our agreement concerning your participation as a Speaker/Presenter/Panelist ( Speaker ) at CTIA Super Mobility 2016 event on September 6-9, 2016 at the Sands Convention Center in Las Vegas, Nevada (the Conference ). CTIA-The Wireless Association, its affiliates, subsidiaries, and its successors and assigns hereinafter called ( CTIA ) and CTIA s contractors will be recording the presentations, panels, sessions, and keynotes at the Conference. To that end, we want to make certain that both you and CTIA have the necessary rights and protections to continue to benefit from your presentation. Photo, Audio, and Video Recording. In consideration for the platform provided to you, and in support of promoting the Conference, future Conferences, and furthering CTIA s educational and informational messaging you grant CTIA the absolute and irrevocable right and permission to: (1) record, stream, film, and photograph your presentation at the Conference, including any written, audiovisual, or other materials that you present at the conference; (2) copyright the photograph, audio, video, film, or other recording, or a portion thereof, in CTIA s name; (3) use, publish, modify, distribute, display, license, or create derivate works from, the photograph, audio, video, or other recording, in whole or in part, individually or in conjunction with other photographs, film, video, or images, in any medium now known or hereinafter developed, and for any non-commercial purpose whatsoever. Examples of permitted uses of the Presentation include: displaying the presentation on CTIA s website, posting a photograph or recorded clip of the presentation on CTIA s social media handles, or incorporating the presentation into a CTIA educational video. Speaker Presentation Materials. You agree to provide CTIA with a copy of any written, audiovisual, or other materials that you present at the Conference ( Speaker Presentation Materials ) prior to your presentation, session, panel, or talk. By participating in this Conference, you grant to CTIA a perpetual worldwide license to use, publish, and make derivative works from the Speaker Presentation Materials for noncommercial purposes, including any Speaker Presentation Materials that are incorporated within any photograph, audio, or video recordings referenced herein. Supporting Information. You agree to provide CTIA with the right to use and publish your name, voice, photographic image, likeness, company address, company related biography, and my company s logos, trademarks, service marks, and copyrighted materials contained therein, in print, audio, video, electronic or other media, in connection with the promotion of the Conference or future Conferences, or for inclusion in any of CTIA s educational or informational messaging; In addition, you warrant that the presentation and any written or verbal material you submit are original, that their publication will not infringe on the rights of others, and that you have full power to grant this license. If your presentation or written materials require permission for use, you have obtained such written permission. You agree to release and discharge CTIA and CTIA s directors, officers, employees and agents from any and all claims and demands arising out of or in connection with CTIA s use of Speaker Presentation Materials, including, but not limited to any claims for or related to defamation, invasion of privacy, or infringement, to the extent such use is consistent with the rights you are granting CTIA.
You understand that by typing your name in the field below, you are certifying that you are of the legal age of 18 or older and have read and foregoing and fully understand the contents thereof. * Check this box if you are submitting this application on your own behalf. Check this box if you are submitting this application on behalf of the speaker.