Chapter Speaker Proposal

Contact Information

Name *
First *
Last *
Title *
Street Address
Address Line 2
State / Province / Region
Postal / Zip Code
Email *
Web Site
Twitter User Name
Facebook User Name
Instagram User Name
LinkedIn Profile Link

About Your Topic

Session Date

Please input the discussed or proposed session date for your topic.
Program Title *
Provide us with a title for your presentation. We will use this title in our marketing efforts for the program.
ATD Competency Model
 Evaluating Learning Impact 
 Training Delivery 
 Learning Technologies 
 Instructional Design 
 Performance Improvement 
 Change Management 
 Integrated Talent Management 
 Knowledge Management 
 Managing Learning Programs 
 Interpersonal Skills 
 Business Skills 
 Global Mindset 
 Personal Skills 
 Technology Literacy 
 Industry Knowledge 
Where does this topic fit within the ATD Competency Model? (Check all that you believe apply.)
Please provide us with the following information:

*Program Description

*Objectives of Program

Additional Program Notes
Program Description:
Provide us with a brief description of your program. We will use this description to market your program on our website.

Objectives of Program:
Please tell us what meeting attendees will be able to accomplish once they've participated in your program.
Source of program content (if applicable)
Please identify the source or sources for your content, if applicable.
Materials Needed
 LCD Projector and screen 
 Special Room Setup 
 Other Special Accommodations 
Identify all the materials you need the chapter to provide. Provide information on special room setup or other accommodations in the notes section. NOTE: the chapter does not provide travel accommodations.

About You

How long have you been in the HR/Training and Development Field
 0 - 5 Years 
 5 - 10 Years 
 10 Years or more 
 I'm not in this field 
How long have you been a member of ATD Baton Rouge?
 0 - 5 Years 
 5 - 10 Years 
 10 Years or more 
 I'm not a member 
How long have you been a member of ATD National?
 0 - 5 Years 
 5 - 10 Years 
 10 Years or more 
 I'm not a member 
Speaker Bio *
Please provide us with a brief bio of yourself. Include any experience that makes you an expert on your presentation topic. We will use this bio on our website and in our marketing for this program.
Speaker Picture *
Please provide us with a picture. We will use this on our website and in our marketing for this program.
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