Subscription Form

Call for Presenters form
The following information must be completed in order to be considered as a presenter at the 2010 Eastern Region, IPMA-HR Training and Development Conference.

Name of Event:

2010 Eastern Region ,
IPMA-HR Training and Development Conference.
Hyattsville, Maryland

Date of Event:

September 19-22, 2010

Submission Deadline:

March 15, 2010

Fields marked with * are mandatory

Salutation:

Mr.Mrs.Ms.Miss.Dr.

First Name (as it should be published)*

Last Name (as it should be published)*

Designation:

IPMA-CPIPMA-CSPHR
Ph.DOthers

Job Title :

Company/Organization:*

Address:*

City:*

State:*

Zip*

Country:

Phone:*
(eg. 5554441212)

Fax:

E-mail:*

Biographical Sketch: *

1500 characters remaining for entering Biographical Sketch

Have you made presentations at other IPMA-HR
events ?

YesNo

In the past year, have you made presentations in the Eastern Region, IPMA-HR ?

YesNo

Will you have a Co-Presenter ?

YesNo

Salutation:	Mr.Mrs.Ms.Miss.Dr.
First Name(as it should be published)*
Last Name(as it should be published)*
Designation:	IPMA-CPIPMA-CSPHR Ph.DOthers
Job Title:
Company/Organization:*
Address:*
City:*
State:*	Zip*
Country:
Phone:* (eg. 5554441212)
Fax:
E-mail:*
Biographical Sketch: *	1500 characters remaining for entering Biographical Sketch

PROGRAM INFORMATION

Title of Session: *

Summary of Session *

1000 characters remaining for entering Summary of Session

Primary Learning Objective :

200 characters remaining for entering Primary Learning Objective

Type of Presentation :

General/Break out Session Presentation
Keynote or Closing Presentation

Will you be submiting a proof of past performance ?
Acceptable forms of proof of performance that can be attached are PDF, JPEG, GIF. For mailing information, see note below.

YesNo

If,Yes

Special Needs (Audio, Visual etc.)

500 characters remaining for entering Special Needs

SUBMITTING YOUR PROPOSAL:

Please send any audio/video tapes/files, or any other proof of performance that you would like to submit, to:

2010 IPMA-HR Eastern Region Program Committee
c/o Mark Van Bruggen, Chair
308 Fieldcrest Drive
New Egypt, NJ 08533-2533

All submissions must be received on or before Monday, March 15, 2010 (midnight EST). The status of all proposals will be acknowledged on or before April 30, 2010.

By submitting your proposal, you agree:
• To adhere to the stipulations as stated in this Call for Presenters
• To adhere to the deadline schedule as furnished by the Program Committee
• To not use your presentation as a showcase for promotion of your business, practice or product
• To not sell products or services from the IPMA-HR speaker platform

I/We agree to the Terms and conditions.