Apply to speak at the 12th ICT4D Conference Apply to Speak at the 12th ICT4D Conference *Required Field Step 1 of 7 14% Speaker Application Information Please read detailed guidance on the Information for Speakers page https://www.ict4dconference.org/participate/call-speakers/ before completing and submitting your application. Closing date for submissions: 23:59 PT December 14 2019 on the status of their submission. Registration and payment of the applicable conference fee must be complete by February 7 2020 to confirm your speaking slot if selected. We will use the information you provide in this form to help us review and select presentations. We need to collect contact and other information from you in order to process your application and inform you of the results. We particularly welcome applications from women, youth and people with disabilities.Name* Prefix Mr.Mrs.MissMs.Dr.Prof.Rev. First Last Email*Please enter a valid, professional email that we can use to inform you whether you have been accepted to speak and to keep you informed of the ICT4D Conference and related developments. If you are applying on behalf of a colleague please ensure you insert their email address here. We will only process the last application received in the case of multiple submissions from the same email address. Enter Email Confirm Email Phone*Please enter your country code followed by your number.Country where you are currently based*AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabweData Protection and Privacy* We would really like to continue sending you the latest updates, information, and invitations to the ICT4D Conference and other events, initiatives and activities. In order for us to be able to do this, we need you to give us permission. To do this, please select the 'I Consent' button below. If you do this, we will be able to keep you on our mailing list. You can still unsubscribe at any time, by clicking on the unsubscribe link at the bottom of our emails. Please see the main website for more details of our Data Protection and Privacy Policy: https://www.ict4dconference.org/privacy-policy/ I consentI do not consentYouth Category*The 12th ICT4D Conference will feature a series of sessions focusing on exceptional innovation in ICT4D by those under the age of 25. Please note that you must be between 18-25 years of age at the time of the Conference to qualify. Please indicate if you would like to be considered. YesNoDate of birth* Date Format: MM slash DD slash YYYY Diversity MonitoringThe ICT4D Conference Committee is working to achieve greater diversity within the faculties of speakers, panellists and attendees. This includes building an accurate picture of the make-up of the conference participants and speakers in encouraging equality and diversity. The organising committee needs your help and co-operation to enable it to do this, but filling in this part of form is voluntary. Please indicate whether you wish to help us by making a selection below:YesNoGender FemaleMalePrefer not to sayDo you consider yourself to be a person with a disability?YesNoCountry of which you are a citizenPlease check visa requirements for entry to Nigeria.AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabweYour Organization's Facebook PageTwitter Organization InformationOrganization Name*Organization Type*Government AgencyMulti-lateral/UNPrivate BusinessSocial Enterprise/Community Based OrganizationEducational InstitutionResearch InstitutionINGOLocal NGOFoundation/DonorMedia/PressOtherIf other, please specify*Speaker’s Job Title* Categorization of PresentationWhich sector does your presentation cover?*Your selection here will help us position your presentation (if selected) in the most appropriate conference track. AgricultureDigital Development in NigeriaDigital Diversity (Gender, Disability)Digital Financial InclusionEducation & Digital LiteracyHealth & NutritionHumanitarian Response & ResilienceResponsible Data and Information SecuritySupply ChainWater Security (WASH & Water Resource Management)Second Preference*Your selection here will help us position your presentation within an alternative conference track if your first preference is not available. Your first and second choice selections may be the same.AgricultureDigital Development in NigeriaDigital Diversity (Gender, Disability)Digital Financial InclusionEducation & Digital LiteracyHealth & NutritionHumanitarian Response & ResilienceResponsible Data and Information SecuritySupply ChainWater Security (WASH & Water Resource Management)Objective of the session*What is the key message or lesson learned you wish to share with the audience? This section may be used in promotional materials and the conference agenda if your application is selected.Which MAIN ICT4D tool or data-centric theme does your presentation PRIMARILY focus on?*We aim to use the ICT4D tool you list here to potentially group speakers together in 90mins session blocks. Please select the primary tool you focus on here.3D Printing5GAnalyticsArtificial Intelligence/Machine LearningAugmented Reality/Virtual RealityBig DataBiometricsBlockchainCloud ComputingConnectivityDigital IdentityDigital ServicesDrones/UAVsGIS / MappingInternet of ThingsMobile DevicesOpen DataPowerPrinciples for Digital DevelopmentPrivacy and Data ProtectionRemote SensingSatellite ImagerySmart SystemsSocial MediaUser-centric DesignVisualizationOtherIf other please specify*Please list ALL the ICT4D tools or data-centric themes you will cover in your presentation?*We aim to use these ICT4D tools to categorize sessions on the online agenda. Furthermore, we may also use them for landscaping/ mapping of ICT4D. Please select all that apply 3D Printing 5G Analytics Artificial Intelligence/Machine Learning Augmented Reality/Virtual Reality Big Data Biometrics Blockchain Cloud Computing Connectivity Digital Identity Digital Services Drones/UAVs GIS / Mapping Internet of Things Mobile Devices Open Data Power Principles for Digital Development Privacy and Data Protection Remote Sensing Satellite Imagery Smart Systems Social Media User-centric Design Visualization Other Rate how technical the session will be*Your selection here will help us ensure a range and balance of technical knowledge across the conference tracks. Non or minimally technical submissions may be grouped into panel sessions on a similar theme.Highly technicalModerately technicalNon/Minimally technicalLocation(s) of implementation or service delivery related to your presentation* Nigeria Other Sub Saharan Africa Asia Pacific Regions Europe Middle East and North Africa North America South/Central America Presentation InformationHave you presented at a previous ICT4D Conference?*YesNoPlease state number of times you have presented at a previous ICT4D Conference1-3More than 3 timesDo not recallPresentation Format*Please select all formats you wish to be considered for. We aim to limit speaking opportunities to one per individual to maximise participation and diversity. For more information on formats see full session descriptions on the Conference Tracks and Formats page on the websitehttps://www.ict4dconference.org/program/conference-tracks/ Presentation/Case Study (40 minutes) Presentation/Case Study (20 minutes) Demonstration Stage Slot (8 minutes) Panel Discussion (40 minutes) Interactive/Knowledge Exchange session (40 minutes) Roundtable (40 minutes) Training Session (40 minutes) Workshop on April 24 ( half day or full day) I would like to be considered for a session arranged by the ICT4D Conference Committee*We may group speakers together in panels on common themes rather than offer a separate presentation. Please indicate if you would like to be considered for this.YesNoProgram Participant/Beneficiary scheme*We encourage speakers to bring a program participant (beneficiary) to co-present. You or the co-presenter are responsible for all costs relating to conference attendance. A limited number of complimentary conference passes may be available to support participant attendance for those selected. Further details will be provided once an offer to speak has been made and accepted.YesNoLocation of Participant/Beneficiary*Location of participant is a criterion used in assessing award for complimentary conference pass. Country AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican 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 RicoQatarRéunionRomaniaRussiaRwandaSaint 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 IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Francophone Presentation OptionWould you like the option, subject to availability, to present your session at the conference in French if you are selected? Please note that your application form and abstract must be completed in English in order for it to be reviewed.YesNoPanel DiscussionPanel discussions must consist of no more than four panelists plus moderator/panel leader. Please list each below. All co-panelists/presenters must confirm attendance by registering at the applicable rate by the published deadlines. See https://www.ict4dconference.org/registration-2/2020registration/Co-presenter One Name* Prefix Dr.Mr.Ms.Mrs.M. First Last Organization*Co-presenter Two Name* Prefix Dr.Mr.Ms.Mrs.M. First Last Organization*Co-presenter Three Name Prefix Dr.Mr.Ms.Mrs.M. First Last OrganizationCo-presenter Four Name Prefix Dr.Mr.Ms.Mrs.M. First Last OrganizationConsent* I provide my consent for submitting the information related to the nomination of the following panel speaker(s) for this session. This information will be shared as necessary and relevant to the ICT4D Conference Committee for the sole purpose of assessing this speaker application. I understand that these details will be processed for no longer than is necessary and are protected by appropriate organizational and technical security measure. For more info on our Data Management practices, please visit the ICT4D Conference website Privacy Policy https://www.ict4dconference.org/privacy-policy/I consentI do not consent Speaker MaterialsAbstract Title*The information you provide in this section will be used to score your application against the selection criteria. It may be used in promotional materials and the conference agenda if your application is selected.Abstract Body*The information you provide in this section will be used to score your application against the selection criteria. It may be used in promotional materials and the conference agenda if your application is selected.Presenter Bio*The information you provide in this section will be used to score your application against the selection criteria. It may be used in promotional materials and the conference agenda if your application is selected.Please upload an image of yourself for conference materials*The image you provide may be used in promotional materials and the conference agenda if your application is selected. Format: jpg preferred png or pdf accepted File size: 2MB maxAccepted file types: jpg, png, pdf.Previous Presentation on this TopicPlease provide a link to any previous presentations you have delivered on this topic Scholarship ApplicationDo you need a scholarship in order to present?*YesNoWhere will you be traveling from?* City State / Province / Region Country AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican 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 RicoQatarRéunionRomaniaRussiaRwandaSaint 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 IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Essay – why do you need a scholarship?*The information you provide in this section will be used to assess your scholarship application against the award criteria. It will not be used in any promotional materials or the conference agenda if your application is selected.If you don’t receive a scholarship do you still want to be considered for a speaking opportunity in the event you are able to find another source of funding?*YesNo ConfirmationI confirm my ability to conduct my session on any one of the Conference days (April 21 - April 23) or workshop on the Training Day (April 24)* Confirm I understand that if I am chosen to speak I will need to confirm my intent to attend the conference by registering at the applicable conference fee by the given deadline.*See https://www.ict4dconference.org/registration-2/2020registration/ for fees Confirm Where did you hear about the conference?* Social media Colleague Organizer Email list-serve Previous attendee at ICT4D Conference Other Please name the organization you heard about this conference from*Please specify social media account, person, email list-serve, or other:*ICT4D Landscaping ProjectWould your organization like to be included in the ICT4D landscape map? This is a data visualisation of ICT4D projects featuring information from the region, sector and ICT4D tools responses you have identified in your application.YesNo
