Presenter Application Form

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Interested in presenting for Medigogy online?

Please fill out the following information as completely as possible. We will contact you once the submission has been received.

Usually your personal cell phone #. It will be used for communications before and during webinars, particularly if any difficulties are encountered.
As a presenter/participant in this webinar, I hereby give Pro D Seminars / Medigogy and its associated websites the right and permission to use, reproduce, publish, transmit, distribute and display photographs and/or video in whole or in part, of me for use in Pro D Seminars / Medigogy promotional or educational materials which include catalogs, brochures, posters, magazines, articles, CD-ROM, DVD, electronic newsletters and the company website. I understand that the Internet is not a secure medium; that any material posted on the Internet is accessible to anyone with Internet access. I hereby waive any right to inspect or approve the video, finished photographs, images, or printed matter that may be used in conjunction therewith or to the eventual use that might be applied.