DR. MANSUR HASIB

AWARD WINNING CYBERSECURITY AND HEALTHCARE LEADER, AUTHOR, AND SPEAKER

Request Form

Please complete the Request Form as fully as possible and provide the following information in your message:


1. Who is your audience (academic/business)?

2. What is your expected audience size?

3. Type of Organization (Non-Profit or For-Profit)

4. Registration Fee for Attendees?

5. What are your speaker benefits (honorarium/travel expenses/guest allowance)?


For speaking engagements, we appreciate at least three weeks notice for events outside the East Coast or International events