Internal Speakers Form

Thank you so much joining us for our 50th anniversary celebrations and agreeing to talk part in the University of Warwick's Festival of the Imagination. We want to create the best possible experience for our speakers so would ask that you fill in this form by the end of August to ensure that your visit and our events run as smoothly as possible.

Should you have any specific queries, please email: 50th.anniversary@warwick.ac.uk or call 02476 150585

Title

First Name

Last Name

Mobile Telephone Number

Twitter Account

Refreshments will be provided throughout the Festival of the Imagination, please indicate if you have any allergies or dietary requirements. If none, please leave blank.

Dietary Requirements and Allergies

TECHNICAL INFORMATION The simplest way of providing information is to email your presentation to 50th.anniversary@warwick.ac.uk and bring a copy of your presentation on a memory stick on the day. If you have any particularly complex requirements, please call the 50th team on 02476 150585

Yes

Please detail any other requirements

DEMONSTRATIONS OR EXPERIMENTS ON STAGE Please give details below about the demonstrations or experiments, note that naked flames are not permitted within any of the venues. Please note that we may require you to fill in a risk assessment form.

Demonstration or experiment details

PRESS AND PUBLICITY

Yes

If yes, please provide the title of your book and details of your publisher:

I understand that my event may be recorded and that photographs may be taken during the event

Please upload a short biography and a photo for use on our website and to share with other speakers and selected invited guests:

Attach file

No files are currently attached.

COMPLIMENTARY TICKETS We have tickets available for guests to attend your own event(s). In addition we have a limited number of tickets available for other events, please state below your requests for additional tickets and we will try our best to accommodate you.

I would like the following number of tickets for my guests to attend my event(s):

Privacy notice

We do not share your personal data with third parties. Your biography and photo will be used on our website in relation to your event.

The University of Warwick is the Data Controller of any information you have entered on this form and is committed to protecting the rights of individuals in line with Data Protection Legislation. The University's Data Protection webpages provide further information on your rights and how the University processes personal data. If you wish to submit a data subjects rights request, make a complaint or report a suspected personal data breach, please contact the University’s Data Protection Officer by email at infocompliance@warwick.ac.uk.

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IMAGINING THE FUTURE

Internal Speakers Form

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