MGMA State Chapter: Request to Present
Thank you for your interest in speaking at an MGMA Chapter event! Please fill out this form to be considered as a speaker. We are looking for passionate and knowledgeable individuals who can provide valuable insights and engage our audience. Complete the form with accurate information about your background, experience, and the topics you are interested in presenting. We look forward to reviewing your application!
Speaker Name
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Company Name
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Email Address
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Mailing Address
Phone Number
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Website (If Applicable)
Are you an MGMA State Chapter Member?
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Yes
No
If you answered yes, which MGMA State Chapter you are a member of?
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Topic / Title of Requested Presentation
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Type of Medium Requested for Presentation (Check all that apply)
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Keynote / Plenary Session
Breakout / Concurrent Session
Webinar
I am open to any medium!
Educational Domain (Check all that apply)
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Financial Management
Organizational Governance
Operations Management
Patient Centered Care
Human Resource Management
Risk and Compliance Management
Other
Brief Session Description
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Session Learning Objectives (Minimum of 3 objectives)
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Please upload any supplemental materials
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Are there fees associated with this presentation?
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Yes
No
If you answered yes, please include the speaker fee amount.
Is there a specific MGMA State Chapter(s) you're interested in speaking to?
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I will speak to any chapter!
Alabama
Florida
Iowa
Maryland / Delaware / Washington, DC
Massachusetts / Rhode Island
Michigan
Minnesota
Nebraska
Nevada
New Jersey
Ohio
Pennsylvania
Texas
Virginia
Washington
Wisconsin
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