Speaker Form

ORGANIZATION INFORMATION

Organization Name*

Industry*

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Number of US Employees:*

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Is the organization a Great Place to Work® Certified Company*

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First Name:*

Last Name:*

Title:*

Email:*

Phone Number:*

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):

Presenter 2 First Name:

Presenter 2 Last Name:

Presenter 2 Title:

Presenter 2 Email:

Presenter 2 LinkedIn

Presenter 2 Bio

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.

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