Apply to Present

Deadline to apply is November 20 No submissions will be accepted after this date.
*If chosen to present, there is a $2,500.00 fee which will include the presenter's registration. This fee is not applied to sponsoring companies.

COMPANY DETAILS

Company Name: *

Is your company private or public? *

Private

Public

Is your company Clinical or Pre-clinical? *

Clinical

Pre-Clinical

Is your company currently fundraising? *

Yes

No

Company Investors: *

Company Website URL: *

Company Description: *

Company Address: *

City

State / Province / Region

Postal / Zip Code

Country

PRESENTATON DETAILS

Presenter Name: *

Presenter Degrees: *

Presenter Title: *

Presenter Department: *

Presenter Company: *

Presenter Email: *

Enter a single email address only.

Presenter Mobile Number: *

Presenter Bio: *

If chosen, what information are you planning to present to the Neurotech audience? *

LOGISTICS & BILLING CONTACT

Logistics Contact:

For approved application, the Logistics Contact will service as primary account holder for our Pre-Event Portal (PEP), which contains all the information and materials needed to prepare for the event. If your application is approved, the Logistics Contact will receive access to PEP and will be responsible for uploading company logo, speaker headshot, and presentation slide deck.

Logistics Contact Name: *

Logistics Email: *

Billing Contact:

For approved applications that include a presentation fee, the Billing Contact will receive an invoice and payment instructions from our Billing Department via email.

Billing Contact Name: *

Billing Contact Email: *

Interested in sponsoring to receive additional visibility and recognition? *

No

Yes

Already committed and confirmed