Expressions of Interest to Exhibit

EXHIBITOR EOI FORM

We invite you to consider exhibiting your organisation at the Summit over two days.
Please complete the EOI Form.

"*" indicates required fields

Contact Name*

First Name Surname

Organisation*

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Mobile*

Email*

Age

Can you share an insight into the work you do, how and why you contribute to your community / region?

What do you hope to learn or gain from networking with other emerging 'doers' during the program?*

Can you tell us about a specific problem or challenge in your local community or region that you are passionate about addressing, and why is it important?*

What motivates you to create solutions and make a positive impact in regional and economic development?*

Why do you believe you would be a strong candidate for the SEGRA Emerging Champions program, and what unique perspectives or qualities would you bring to the group?*

Please upload your resume

Max. file size: 128 MB.

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Expressions of Interest to Exhibit

EXHIBITOR EOI FORM

Our Values

Inclusive

Evidence Based

Bi Partisan

Solutions Driven

Regional focus

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