First name:
Last name:
Job title:
Company name:
Phone:
Email:
City:
State:

Event title

Event description

Please write a brief description for the following:

1. Describe the issue or problem that your presentation will address.

2. Describe how your presentation will address this issue or problem.

3. Why will this be a topic of interest to the attendees?
(i.e., How will they benefit?)

Objectives

Please list 4-6 things the attendees will learn by attending this event.

List your target audience

1.
2.
3.

Audience level

Novice
Intermediate
Advanced

Audience knowledge

Please indicate what knowledge or skill attendees should have in order to gain the most benefit from attending your event.

Do you have your own list of attendees you would like to invite to this event?
Yes
No

If yes, approximately how many people would you like to invite?

Speaker biography

Briefly highlight your career or educational experience, awards, etc. Please do not describe company products or services.

Speaking experience

Please list your experience conducting online sessions or events.

Give a brief description of your organization

Event sponsers

Do you have sponsors who will be co-marketing your event? If yes, list name of sponsor.