Chief Disruptor LIVE: Virtual April 2021

First Name*

Last Name*

Job Title*

Company Name*

Email (Business)*

Mobile Phone Number*

Twitter Username:

LinkedIn Username:

Information for promotional collateral

Please attach your organisation's logo in .ai or .eps*

Please provide a short summary about your organisation. This will be used on our website to promote you as a supporting partner.*

I'm aware the session will be recorded and published online, and that the media I provide will be published for marketing purposes only.*

What day will you be joining us as a Supporting Partner?

DAY ONE: Lead Through Disruption
DAY TWO: Future Focus

As a Supporting Partner you have full access to both event days. Please tick the parts of DAY ONE: Lead Through Disruption, that you would like to join:

Please tick the parts of DAY TWO: Future Focus, that you would like to join:

As a Supporting Partner you are entitled to 3 free tickets, please let us know who you would like to invite as your guest? *Please note they must be B2C, charity or public sector, if not from the supporting partner organisation

Guest 1

Name

Job title

Company

Guest 2

Name

Job title

Company

Guest 3

Name

Job title

Company

Chief Disruptor LIVE Supporting Partner Form

It's a short form, we promise!

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