Deadline for submissions was February 26, 2016.
(Email firstname.lastname@example.org to inquire about submission options after this date.)
NOTE: Up to 2 submissions per speaker * = Required field
Speaker Content Proposal Form
*Speaker/Moderator First Name:
*Speaker/Moderator Last Name:
Designations/Certifications: (If applicable):
*Firm Name (To be used on speaker agreement if selected):
*Address 1 (To be published on Conference website if selected):
*E-mail Address (Speaker agreement will be sent electronically to this address if selected):
Additional Email (send copy of all communications to this email):
Website/Blog URLs (List up to two):
*Using Co-presenter(s) or Panel member(s)?
Co-Presenter/Panelist Name, Address, Phone and E-mail Address (If selected, the speaker agreement will be sent electronically to this address):
*Primary Audience for Presentation:
Choose the most appropriate topic
*Title of Presentation:
8 words or less. Topic, audience focused (subject to editing). The conference theme should NOT be part of the title.
*List three primary learning objectives. If selected, these objectives will be used to write promotional copy for your session:
NOTE: List up to three things attendees will be able to do upon completion of your session. Use quantifiable/action verbs such as identify, list, describe, analyze, implement.
Content requires following understanding of the topic:
*Specify audio/visual equipment needed:
(Standard room setup is theater style seating. Specify if alternate room setup is preferred.)
*Indicate the Presentation Format of your session:
*Attach a one page program outline and a one page speaker bio or resume (NOTE: Indicate date of content creation or revision on program outline).
Click Browse to search your computer for the document files you want to attach. NOTE: Outline must be attached for us to consider your submission. Outline: Bio/Resume:
*Length of Presentation: (Choose one)
*If selected would you be willing to submit a speaker tip video?
Indicate when and where you made your last three presentations (date, contact name and phone number, organization, topic and title of the presentation).
(Do not include NAR conferences; we already have those on file.)
If someone recommended that you complete a submission, please provide contact name, organization name, address, telephone and email of the individual:
To ensure your submission is considered:
Complete this form in its ENTIRETY -- Make sure 1 Page Outline and Speaker Resume are ATTACHED -- PRINT a copy for your records before submitting. CLICK on the Submit Proposal Button below to submit.