ASSP Safety 2019 Call for Presenters

Incomplete submissions will not be considered.

Proposals are due no later than July 18, 2018

* = Required Question
Step #1: Speaker Information (If you have more than 3 speakers, list the additional speaker, with contact information, in the presentation description.)

LAST Name *This question is required.

First Name *This question is required.

Middle Initial

Designations/Certifications (Max of 3)

Designations/Certifications

ASSP Member?

What social media are you on?

Facebook
LinkedIn
Twitter

Job Title

Organization *This question is required.

Address *This question is required.

City *This question is required.

State

Province

Postal Code

Country *This question is required.

Email Address *This question is required. This question requires a valid email address.

Phone Number
Format (xxx) xxx-xxxx unless international *This question is required.

Mobile Number
Format (xxx) xxx-xxxx unless international

Speaker 2

LAST Name (SPEAKER 2)

First Name (SPEAKER 2)

Middle Initial (SPEAKER 2)

Designations/Certifications (SPEAKER 2)

ASSP Member? (SPEAKER 2)

What social media are you on? (SPEAKER 2)

Facebook
LinkedIn
Twitter

Job Title (SPEAKER 2)

Organization (SPEAKER 2)

Address (SPEAKER 2)

City (SPEAKER 2)

State (SPEAKER 2)

Province (SPEAKER 2)

Postal Code (SPEAKER 2)

Country (SPEAKER 2)

Email Address (SPEAKER 2) This question requires a valid email address.

Phone Number (SPEAKER 2)
Format (xxx) xxx-xxxx unless international

Mobile Number (SPEAKER 2)
Format (xxx) xxx-xxxx unless international

Speaker 3

LAST Name (SPEAKER 3)

First Name (SPEAKER 3)

Middle Initial (SPEAKER 3)

Designations/Certifications (SPEAKER 3)

ASSP Member? (SPEAKER 3)

What social media are you on? (SPEAKER 3)

Facebook
LinkedIn
Twitter

Job Title (SPEAKER 3)

Organization (SPEAKER 3)

Address (SPEAKER 3)

City (SPEAKER 3)

State (SPEAKER 3)

Province (SPEAKER 3)

Postal Code (SPEAKER 3)

Country (SPEAKER 3)

Email Address (SPEAKER 3) This question requires a valid email address.

Phone Number (SPEAKER 3)
Format (xxx) xxx-xxxx unless international

Mobile Number (SPEAKER 3)
Format (xxx) xxx-xxxx unless international

Step #2: Presentation Information

Title of Presentation (limit 60 characters including spaces) *This question is required.

Presentation Details *This question is required.

Format (select one) *This question is required.

Step #3: Topic Area: Select up to three topic areas in which your presentation fits best.
First Choice *This question is required.

Second Choice

Third Choice

Step #4: Presentation Description: Maximum length is 600 words. *This question is required.

Step #5: Learning Outcomes: Specify 1-3 primary learning outcomes for your session. (Maximum 30 words per item)
Learning Outcome #1 *This question is required.

Learning Outcome #2

Learning Outcome #3

Step #6: Topic Relevance: Describe why this topic is relevant to attendees and the profession. (Maximum 150 words) *This question is required.

Step #7: Speaking Experience: Describe (or list) the presenter's relevant speaking experience, at the ASSP PDC, other society presentations and/or presentations in other venues. (Maximum 300 words) *This question is required.

Step #8: Biographical Information: See the Details to Submit a Proposal section for the information to include. (Maximum length is 1 page) Please upload a MS Word, PDF, or Text file only.
You may upload more than one file if there are multiple speakers.
Browse... to find and open your file. Click Upload to attach your file. *This question is required.

File: {{filename}} delete

Step #9: Abstract/Brochure Description: Provide a description of the presentation (max 300 characters) to include in the conference brochure. *This question is required.

Step #10: Sponsored by an ASSP Practice Specialty? (Not Required)
Sponsorship will be verified.

Sponsored by an ASSP Practice Specialty? (This applies if more than 1 PS is sponsoring your session.)
Sponsorship will be verified.

Step #11: Sponsored by an ASSP Committee or Common Interest Group? (Not Required)
Sponsorship will be verified.

Sponsored by an ASSP Committee or Common Interest Group? (This applies if more than 1 ASSP Committee or CIG is sponsoring your session.)
Sponsorship will be verified.

Step #12: (Optional)
If you have never presented at an ASSP PDC before and would like the opportunity to showcase your speaking skills, here's your chance! Copy and paste your YouTube, Vimeo or similar link into the box below.