CompDev Speaker Registration - Central Iowa SHRM

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Competency Development Workshop Speaker Registration

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Please note, speakers are asked to bring their own laptops for their presentations.
Organization *
First Name *		Last Name *
Professional Title *
Email Address *
Address Line 1 *
Address Line 2
City *		State *
Zip/Postal Code *		Phone *
Title of presentation *What topic or subject will be presented
Presentation/Session Description *Please upload Description/Outline/Agenda
Presenter Bio *Please upload your presenter Bio
Describe your qualifications to present on this topic.e.g. degrees, license and relevant training, or clinical experience or research
What are the 3 key things the audience will be to implement in their workplaces? *What are the 3 key things the audience will be able to implement to their workplaces?
What opportunities will the audience have to participate? *What opportunities will the audience have to participate?
What materials (if any) will be distributed?What materials (if any) will be distributed?
Has the speaker(s) presented on this topic in the past and if so when and where? *Has the speaker(s) presented on this topic in the past and if so when and where?
Speaker Fees *Speaker Fees:
Any Additional Fees Required: *Any Additional Fees Required:
Has the presentation been approved for SHRM credit.Is this SHRM creditable?		If yes, how many credits?How many HRCI credits does a participant receive?
AV NeedsAV Needs	LCD Projector Podium Microphone Access to Internet	My presentation contains audio and/or video clips.My Presentation contains audio and/or video clips.

Are you a members of CISHRM?Are you a members of CISHRM?		Are you a member of SHRM?Are you a member of SHRM?

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