Speaker Proposal Application
Please complete the form below. Items with a red asterisk are required.
Speaker Information
Full Name
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First Name
Last Name
Email Address
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Phone Number
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Area Code
Phone Number
Website (if applicable)
I am an...
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ATD Central Indiana Chapter Member
ATD National Member
ATD Chapter Member (not ATD-CIC)
not a member
Presentation Information
Please tell us about your proposed presentation and topic below.
I am applying to (select all that apply).
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Speak at a monthly meeting (60 minutes)
Facilitate a workshop (outside of a monthly meeting) (Length TBD)
Present at a breakout session at the Learning Summit on 11/1/24 (60 minutes)
Keynote at the Learning Summit on 11/1/24 (60 minutes)
Title
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Short Description
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Response limited to 500 characters.
Learning Objectives
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Include up to five.
Presentation Modality
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Live, virtual, blended, etc.
Select the audience level to which your content most relates:
Entry-level
Experienced
Executive
Please describe how your content will be tailored to a diverse audience and/or address intersectionality.
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Select the primary capability of the Talent Development Capability Model with which this presentation best aligns.
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Building Personal Capability
Developing Professional Capability
Impacting Organizational Capability
Describe how this presentation aligns with the sub-capabilities of the primary capability you selected above.
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Include up to five.
Additional Information
Have you presented this topic before?
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If yes, please explain
Please provide links where we can watch you present , if you have them (does not have to be this topic).
Please provide the names and contact information of 2-3 references who can speak to your experience and effectiveness as a speaker. Include their relationship to you and any relevant details.
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Any additional information you'd like to share.
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If you have additional files you'd like to share (bio, course outline, etc) upload those here.
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