EVENT REGISTRATION FORM

CISO Virtual Roundtable

"*" indicates required fields

Hidden

Event Title

Name*

Please ensure your name is written as you would like it presented on your name badge. Please also include 'title' if you would like this included

First Last

Preferred Pronouns*

The preferred gender pronoun that you would like others to use when talking to or about you

Corporate Email*

Please include corporate email as validation that you are currently employed

Cell Phone*

Your phone number will not be shared. We do not share your cell phone with third parties

LinkedIn Profile*

Used for verification purposes, helping ensure that this is the right event for you

Current Job Title*

Used for verification purposes, helping ensure that this is the right event for you

Current Employer*

The format of this event requires that you are currently employed. Please ensure to write the company name as you would like it presented in the event

Do you have responsibility for any of the following?*

Please specify which area is most interesting for you to discuss*

Do you have active projects/current initiatives, or challenges that you would like to discuss?*

Please summarize your top challenges you need assistance with in the next 3-6 months. Providing this information helps us guide discussion content*

Share any details that can help us improve the discussion to ensure it is valuable to you

Where did you hear about this event?*

The Kodi team work hard to bring the best people together

Promo Code (If Applicable)

CAPTCHA

This field is for validation purposes and should be left unchanged.

EVENT REGISTRATION FORM

CONTACT US

QUICK LINKS

ONLINE SOLUTIONS

IN-PERSON SOLUTIONS