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Speaker Proposal Form

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Name 
Title 
Company 
Address 
City 
State 
Zip Code 
Phone 
Fax 
Email Address 
What events are you interested in speaking at? (Check all that apply)  IAB MIXX Conference & Expo (September 27-28, 2010)
IAB Ad Operations Summit (November 1, 2010)
IAB Annual Leadership Meeting (February 2011)
IAB MIXX Conference & Expo (September 2011)
Check All
Speaker's Biography 
 
Presentation Structure (Panel--Brand Marketer Case Study--Research/Market Update) 
 
Presentation Title and Description 
 
Five Key Benefits of Presentation 
 
Additional Panelists to be Considered (Name, title and affiliation) 
 


PRIMARY POINT OF CONTACT
Who should we contact with questions about the proposal?
Contact Name 
Contact Phone 
Contact Email