Speaker Signup
  1. Speaker Information Form
  2. Ensure that all information provided is accurate prior to submission. The information you provide will be used to aid in the selection process.
  3. Personal Information
  4. Full Name(*)
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  5. Designations (i.e. PMP)(*)
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  6. University / College(*)
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  7. Degrees (Check all that apply)
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  8. Address(*)
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  9. City(*)
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  10. State / Province(*)
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  11. Zip / Postal Code(*)
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  12. Country
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  13. E-Mail Address(*)
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  14. Website
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  15. Daytime Phone(*)
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  16. Fax
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  17. Mobile
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  18. Professional Information
  19. Company / Organization
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  20. Title
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  21. Role / Responsibilities
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  22. Professional Industry Experience
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  23. Experience Duration
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  24. Awards / Industry Recognition
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  25. Affiliations / Board Memberships
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  26. Publications (Most Recent)
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  27. Prior Speaking / Lecturing Engagements
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  28. List any References You Would Like to Include
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  29. Personal / Professional Biography
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  30. Presentation
  31. Session Title:
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  32. Session Type (check all that apply)(*)
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  33. Preferred Session Length(*)
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  34. Description of Presentation and Topics to be Covered (200 words or less)(*)
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  35. Learning Objectives(*)
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  36. Who Should Attend Your Session? (Geared toward positions/levels)
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  37. What Instructional Materials will be used (i.e. case studies, discussions, etc.)?
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  38. How many PDU credits can be awarded (i.e. 1 PDU / hr)?(*)
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  39. Have you presented this topic at other events?(*)
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  40. If "Yes", list event(s) and date(s)
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  41. Have you presented a topic at a previous PMI Tampa Bay event?(*)
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  42. If "Yes", list date(s) and topic
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  43. Miscellaneous
  44. Are you willing to present your topic at two separate scheduled times on Saturday should the opportunity arise?(*)
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  45. Will you require handouts for your session?(*)
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  46. Please list your travel reimbursement requirements:(*)
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  47. Please list any special requiremetns you have for your presentation (including all A/V requirements)
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  48. Comments
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  49. Enter the text from the image(*)
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  50. Submit request

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