Speaker Form

ORGANIZATION INFORMATION

Organization Name

Industry

Number of US Employees:

Is the organization a Great Place to Work® Certified Company

Submitted by:

First Name:

Last Name:

Title:

Email:

Phone Number:

PRIMARY PRESENTER INFO (if different than above)

Presenter 1 First Name:

Presenter 1 Last Name:

Presenter 1 Title:

Presenter 1 Email:

Presenter 1 LinkedIn

Presenter 1 Bio

Presenter Past Speaking Engagement Video Link (If Any):

SECONDARY PRESENTER INFO (if applicable)

Presenter 2 First Name:

Presenter 2 Last Name:

Presenter 2 Title:

Presenter 2 Email:

Presenter 2 LinkedIn

Presenter 2 Bio

FOCUS SESSION INFO

Proposed Focus Session Title

Please be specific as possible so that your title reflects the content and key objectives

Proposed Focus Session Description

Limit 255 characters

Three Key Learning Objectives

It’s important that these are as specific and tactical as possible.

What makes your presenter a unique individual to speak about the current state of your workforce?

Panel?

If your session is not selected, would your presenter be willing to speak on a panel of leaders during the summit?

Yes

How will your presenter work to create a memorable and interactive experience with our attendees

Please be as specific as possible. Limit 255 characters.

Send me a copy of my responses