Call for Speakers

Name(Required)

First Last

Credentials

Company/Facility Name(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone(Required)

Email Address(Required)

Title of Presentation(Required)

Session Description: In 100 words or less clearly describe the content of your presentation. This description will be used by the committee during the speaker selection process.(Required)

Provide 2-3 sentences explaining the content of your presentation and what the attendee will learn. This information will be included in the pre-meeting promotional brochure. ILHIMA reserves the right to edit this information.(Required)

What fees/expenses do you charge for presenting?(Required)

List any organizations that have heard your presentation and include the contact person for that organization, along with phone and email.

Please attach your photo.

Max. file size: 256 MB.

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