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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E-MAIL ADDRESS  *
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.
*
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.
*
BADGE DISPLAY FIRST NAME
OPTIONAL - required only if you want a name OTHER than your legal first name printed on your badge.
BADGE DISPLAY LAST NAME 
OPTIONAL - required only if you want a name OTHER than your legal last name printed on your badge.
JOB TITLE
As you want it printed on your badge.
*
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.
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).
*
CITY
If not applicable, list N/A.
*
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.
*
POSTAL CODE/ZIP CODE
If not applicable, list N/A
*
COUNTRY *
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.
*
BUSINESS PHONE NUMBER
OPTIONAL
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.
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ISC(2) Certificate #
Optional for reporting CPE credits to ISC(2).  You are eligible to receive 14 credits for attending Briefings.
BRIEFING SESSION TITLE *
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.)
Additional Comments - Optional
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