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UNANZ 2026 Speech Competition Entry Form

First Name

Last Name

Preferred Name

Email

Phone

Date of Birth

Which category are you entering?

Which category are you entering?

Gender

What are your pronouns?

Submission Information:

Link to your unedited video entry:

Bibliography and References:

To acknowledge authors, and allow for fact-checking, please paste your bibliography of sources cited below:

Presentation Verification Checkbox:

Presentation Verification Checkbox:

Do you have any dietary requirements?

Do you have any medical requirements?

Do you have any accessibility requirements?

Is there anything else we can do to improve your experience?

Alternative Contact First Name

Alternative Contact Last Name

Alternative Contact Email

Alternative Contact Phone

Relationship to Alternative Contact?

Declarations:

Declarations:
Signature