Speaker Proposal Form - Re-Entering Antibacterial Discovery and Development Summit

Please Select a Track

Proposal Title:

* 2-3 Sentence Summary (approx. 70 words):

Why your proposal should be considered:

What the audience will gain from your presentation:

Short Biography: (Bio may be used in print material if proposal is accepted)

Select : Mr. Ms. Mrs. Dr. Prof.

First Name:

Last Name:

Degree / Credential: (eg. Ph.D. or FACR etc.)

Job Title:

Department:

Company/Organization:

Mailing Address:

City:

State or Province (Canada):

Zip / Postal Code:

Country:

Phone:

Ext:

Fax:

Email:

Your Organization Website:

ORCID iD

(Open Researcher and Contributor ID) is a nonproprietary alphanumeric code to uniquely identify scientific and other academic authors and contributors.

LinkedIn Profile

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