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Black Hat Asia 2025 - Contributor Registration Form
-We will use this information to register you for one (1) speaker badge (which includes access to all Briefings and the Business Hall).
-
Please note that Black Hat provides a maximum of 5 speaker badges (Briefings passes) per session for speakers + contributors.
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* Indicates required question
E-MAIL ADDRESS
*
Your answer
LEGAL FIRST NAME/GIVEN NAME
Must match your passport or government issued photo ID, which you will be required to display when you pick up your badge.
*
Your answer
LEGAL LAST NAME/SURNAME
Must match your passport or government issued photo ID, which you will be required to display when you pick up your badge.
*
Your answer
BADGE DISPLAY FIRST NAME
OPTIONAL - required only if you want a name OTHER than your legal first name printed on your badge.
Your answer
BADGE DISPLAY LAST NAME
OPTIONAL - required only if you want a name OTHER than your legal last name printed on your badge.
Your answer
JOB TITLE
As you want it printed on your badge.
*
Your answer
COMPANY NAME
As you want it printed on your badge.
Leave it blank, if you do not want your company name printed on your badge.
Your answer
STREET ADDRESS
Required for event registration -
We recommend that you list your company address and not your home address, as the address can be viewed by your connections in the Mobile App
(if you accept a connection request).
*
Your answer
CITY
If not applicable, list N/A.
*
Your answer
STATE/Province/Territory
Required for event registration if your country is: United States, Brazil, Italy, Mexico, Canada, India, China, Australia, Ireland, or United Kingdom. If not applicable, list N/A.
*
Your answer
POSTAL CODE/ZIP CODE
If not applicable, list N/A
*
Your answer
COUNTRY
*
Your answer
MOBILE PHONE NUMBER
Required for event registration and to confirm banking details if you are a new speaker receiving a payment. Be sure to include the country code.
*
Your answer
BUSINESS PHONE NUMBER
OPTIONAL
Your answer
Do you need a letter of invitation (LOI) for a Visa application?
If yes, immediately notify jennifer.hughes@informa.com upon completion of this form, so we can immediately respond to your request.
Yes
No
Clear selection
ISC(2) Certificate #
Optional for reporting CPE credits to ISC(2). You are eligible to receive 14 credits for attending Briefings.
Your answer
BRIEFING SESSION TITLE
*
Your answer
MEALS
With your Briefings pass, you will receive a continental breakfast and lunch on April 3 & 4.
If attending in-person do you have any special dietary needs?
(Halal, Kosher, etc.)
Your answer
Additional Comments - Optional
Your answer
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