2019 Cucalorus Connect Application November 14-15, 2019 | Brooklyn Arts Center 2019 Cucalorus Connect Application Business Name * Cucalorus Connect Conference Track * GigTech FinTech HealthTech Startups (If you'd like to apply to our 10x10 Challenge or Rocket Pitch competition, please click here.) Community Brew None of the above Please indicate which track is most applicable for your session topic. A brief description of each track can be found here. Entrant First Name * Last Name * Job Title * Email * This is how we will contact you Street Address * City * State * Country * Zip * Phone * Company Website * Social Tags Twitter, Instagram, etc. Description of speaker, presentation, workshop, panel, and/or event * [50 words or less] (this will be used in press and print) Description of your Industry * Why would you like to be a part of Cucalorus Connect? * By signing this entry form, you are representing that you have read and fully understand this form, as well as our Submission Requirements and policies, and you are warranting that you have the full legal right and authority to submit to Cucalorus Connect. *