Speaker Proposal Application
Please complete the form below. Items with a red asterisk are required.
Speaker Information
Full Name
*
First Name
Last Name
Email Address
*
Phone Number
*
-
Area Code
Phone Number
I am an...
*
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.
Title
*
Short Description
*
Response limited to 500 characters.
Learning Objectives
*
Include up to five.
Length of Presentation
*
Modality
*
Live, virtual, blended, etc.
Describe how this presentation supports the ATD Competency Model.
*
Additional Information
Have you presented this topic before?
*
If so, please explain
Please provide links where we can watch you present. (does not have to be this topic)
Any additional information you'd like to share.
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Upload a File
If you have additional files you'd like to share (bio, course outline, etc) upload those here.
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