Speaker confirmation formA3P Aseptic processing – May 10th & 11th✻Intervention confirmationA3P Aseptic processing event in Milan on May 10th and 11th*I agree to be a speakerConference detailTitle of the conference in English:*Title of the conference in Italian:Could you summarise the content of your conference in a few lines? What key message(s) would you like to convey to the audience?Can you give us a question that the audience is likely to ask you at the end of your lecture?This can help the moderator to launch the Q&A.Conference languageI will speak in:*EnglishItalianLanguage of conference material - Please use English as the preferred language for the conference material (PowerPoint).*EnglishItalianGeneral ConditionsCommunication:*I authorize A3P to mention my name in the communication related to this event (website, social networks, press...).Image rights*In accordance with the provisions relating to image rights, I authorise A3P to use the photographs and videos taken during this event to illustrate A3P's communication actions, without any compensation and without any time limit.Conference support*I authorise A3P to make my conference materials available to members of the association (.pdf format)I do not authorise A3P to make my conference materials available to members of the association (.pdf format)Information SpeakerCivility:*Mr.Mrs.First name last name* First name Last name Company:*Function:*Adress :* Adress City Postal code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country E-mail :* Phone number:*Prefer a mobile phone numberPresentation of the speaker - Professional backgroundWrite us a few words about your professional background. This may help us in our communication and/or to introduce you to the participants.The A3P association supports:Speakers' dinner:*I will attend the speakers' dinner on May 09thI am not participating in the dinner speakerHotel booking:* I need a hotel room for the night of May 09th I need a hotel room for the night of May 10th No, I don't need a roomOpen field if you have a specific point to make:PhoneThis field is for validation purposes and should be left unchanged.
