Annual Meeting Speaker Proposal Form

Are you human?
Leave this empty if you are a human. This is to prevent spam. Name:* Title* Company Name* Phone Number:* Email Address:* Website: Mailing address:

Topic(s):*

Learning Objectives: (Learning Objectives are what you believe the attendee will gain from the session)*

Session Outline: (The Session Outline should present sufficient detail to enable the Program Committee to clearly understand the content and sequence of the information to be provided during the session)*

References: (Please list other HIM conferences where you have presented, along with contact information)*