NAMI Utah State Conference 2019 Speaker Application
October 10, 2019, Salt Lake Community College, Miller Campus, Sandy UT
Speaker Application Form - Break-out Session
Due to popularity and time limits of this conference, not all applicants will be chosen to speak.
Name
*
Prefix
First Name
Last Name
Suffix
How your name/title should be listed in program
Example: Dr. John Smith, John Smith, MBA, John Smith, PhD
Email
*
example@example.com
Phone Number
-
Area Code
Phone Number
Website
Optional
Company & Professional Credentials
*
Include your qualifications to speak on this subject.
Title of Presentation
*
Presentation Description (up to 200 words of what attendees will learn/take away.
*
0/200
Speaker's Intended Audience
*
Professional/Provider
Constituents/Family
Both
Other
Presentation Material
*
Powerpoint
Handouts
Other
A/V Equipment required from venue or NAMI Utah
Flip Chart & Markers
Internet Access
Power
Other
Question for NAMI Utah?
0/100
Speaker Proposal Requirements and Goals of Break-out Sessions
NAMI Utah is seeking qualified candidates to present as break-out session speakers at NAMI Utah 2019 Conference, All Around Wellness, our annual mental health conference for providers, constituents and family members of people with mental illness. To be considered as a speaker, please complete and submit this completed form to Sue Weaver. PROPOSAL REQUIREMENTS: • All sessions should fit within NAMI Utah’s mission of helping people with mental illness, their families, and mental health professions/service providers. • We seek to provide a broad spectrum of choices for breakout sessions, covering a wide variety of topics. See tentative agenda below for 4 tracks with four breakout sessions each. • The most valued quality we look for in a proposal is that we can easily recognize any practical takeaways that attendees can expect from your session based on its description. • Multiple session proposals are permitted. • Additional attachments are permitted. SPEAKER REQUIREMENTS: Speakers must sign the Speaker Agreement and Release form, agreeing that: • You will meet deadlines for providing information and materials, such as speaker biography and photo, session title and description, and draft slides and materials. • You consent for NAMI Utah to publicize your involvement with our conference, distribute handouts, and to record your presentation for specified uses. • Your presentation and materials are your original work and/or you have legal rights to use them. SESSION REQUIREMENTS: • Session must have educational and/or practical value that is not dependent on purchasing a particular product or service. Sessions must not be sales pitches. • All sessions are scheduled for one hour and must last at least 50 minutes due to CEU requirements. • Session rooms are equipped with a laptop to run slides, microphones and speakers, projector and screen, and a remote clicker to advance slides. Our ability to provide additional support will be dependent on cost and availability. Contact Sue Weaver at NAMI Utah with any questions, suew@namiut.org, 801 869-2883. Thank you for your interest in presenting at the 14th Annual NAMI Utah State Conference.
I have read the requirements and goals, and
*
I agree with the goals for the break-out sessions.
I do not agree with the goals for the break-out sessions.
Break-out Sessions You're interested in.
*
Physical
Self-care
Emotional
Self-care
Social
Self-care
Spiritual
Self-care
Morning
Morning
Afternoon
Afternoon
For more information about the break-out sessions and times, please visit our website at https://www.namiut.org/news-and-events/nami-utah-state-conference
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