Call For Speakers Application

Primary Presenter contact information:

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Co-Presenter contact information: (optional if the primary presenter is a provider)

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Session information:

Is this proposal for*:

Presentation Category* (please select the category you feel best fits your presentation)







limit to 75 words

Three learning objectives*:

Use this space for any additional information that you feel may be valuable for the selection committee. Limit to 100 words.
Would you be interested in presenting this topic in our HCIC: Backstage Pass webinar series? (Someone will contact you regarding pricing, scheduling, etc.)

Would your company be interested in facilitating a networking roundtable at HCIC on Tuesday November 8, 2022? (You will be contacted if your topic is chosen.)

Select
Have you given, or will you be giving, this presentation at another educational conference?

Select
If the proposal is accepted, I agree on behalf of myself and any co-presenter to meet all deadlines by the conference organizers (Greystone.Net) and you may be asked to record your presentation in advance of the actual conference date. Details will be worked out with each speaker.

I agree not to change content or presenters without the express written consent of the organizers. I understand that I am responsible for all costs of presentation, including travel, hotel, per diem and fee for attending. I agree to stay at the JW Marriott Turnberry in Aventura, FL.

I grant the conference sponsor the right to audiotape, videotape, photograph, distribute and/or post online the presentation and handout, for profit or otherwise.

Attendance at HCIC constitutes consent to be photographed and/or videotaped for use in print and/or electronic publicity for Greystone.Net and HCIC.
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