Speaker confirmation formA3P Quality risk management – November 30th✻Intervention confirmationA3P Quality risk management event in Milan on November 30th*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 AfghanistánAlbaniaAlemaniaAndorraAngolaAnguillaAntigua y BarbudaAntártidaArabia SauditaArgeliaArgentinaArmeniaArubaAustraliaAustriaAzerbaiyánBahamasBangladeshBarbadosBaréinBeliceBeninBermudaBhutánBielorusiaBoliviaBonaire, San Eustaquio y SabaBosnia y HerzegovinaBotswanaBrasilBrunei DarussalamBulgariaBurkina FasoBurundiBégicaCabo VerdeCamboyaCamerúnCanadaChadChileChinaChipreColombiaComorasCongo, República Democrática delCongo, República deCorea del NorteCorea del SurCosta RicaCosta de MarfilCroaciaCubaCurazaoDinamarcaDjiboutiDominicaEcuadorEgiptoEl SalvadorEmiratos Árabes UnidosEritreaEslovaquiaEsloveniaEspañaEstados UnidosEstoniaEswatini (Suazilandia)EtiopíaFijiFilipinasFinlanciaFranciaGabónGambiaGeorgiaGhanaGibraltarGranadaGreciaGroenlandiaGuadalupeGuamGuatemalaGuayanaGuayana FrancesaGuernseyGuineaGuinea BissauGuinea EcuatorialHaitíHondurasHong KongHungríaIndiaIndonesiaIraqIrlandaIránIsla BouvetIsla NorfolkIsla de ManIsla de NavidadIslandiaIslas CaimánIslas CocosIslas CookIslas FaroeIslas Heard y McDonaldIslas MalvinasIslas Marianas del NorteIslas MarshallIslas SalomónIslas Turcas y CaicosIslas Ultramarinas Menores de Estados UnidosIslas Vírgenes BritánicasIslas Vírgenes de los Estados UnidosIslas ÅlandIsraelItaliaJamaicaJapónJerseyJordánKazajistánKeniaKirguistánKiribatiKuwaitLIbiaLaosLesotoLiberiaLiechtensteinLituaniaLituaniaLuxemburgoLíbanoMacauMacedoniaMadagascarMalasiaMalawiMaldivasMaliMaltaMarruecosMartinicaMauricioMauritaniaMayotteMicronesiaMoldaviaMonacoMongoliaMontenegroMontserratMozambiqueMyanmarMéxicoNamibiaNauruNepalNicaraguaNigeriaNiueNoruegaNueva CaledoniaNueva ZelandaNígerOmánPaises BajosPakistánPalauPalestina, Estado dePanamáPapúa Nueva GuineaParaguayPerúPitcairnPolinesia FrancesaPoloniaPortugalPuerto RicoQatarReino UnidoRepública CentroafricanaRepública ChecaRepública DominicanaReuniónRuandaRumaníaRusiaSahara OccidentalSamoaSamoa AmericanaSan BartoloméSan Cristóbal y NievesSan MarinoSan MartínSan Pedro y MiquelónSan Vicente y las GranadinasSanta ElenaSanta LucíaSanta SedeSanto Tomé y PrincipeSenegalSerbiaSeychellesSierra LeonaSingapurSint MaartenSiriaSomaliaSouth GeorgiaSri LankaSudáfricaSudánSudán del SurSueciaSuizaSurinamSvalbard y Jan MayenTailandiaTaiwanTanzaniaTayikistánTerritorio Británico del Océano ÍndicoTierras Australes y Antárticas FrancesasTimor OrientalTogoTokelauTongaTrinidad y TobagoTurkmenistánTurquíaTuvaluTúnezUcraniaUgandaUruguayUzbekistánVanuatuVenezuelaVietnamWallis y FutunaYemenZambiaZimbaue 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 November 29thI am not participating in the dinner speakerHotel booking:* I need a hotel room for the night of November 29th No, I don't need a roomOpen field if you have a specific point to make:NameEste campo es un campo de validación y debe quedar sin cambios.
