Exit this survey 2013 Education Conference - Call for Speakers Speaker Application for IIA Southern California Education Conference June 3, 2013 • Sharaton Anaheim Hotel • Wrd4ec.org** Directions: Please include as much detail as possible in this application. Once we receive all speaker applications we will review them and make the selection. Confirmation will be sent after all applications are reviewed. For any question please contact Jason James: Jason.james@regentsandpark.com Question Title * 1. Please provide the following information: First Name Last Name Title Company Street Address City State Zip Question Title * 2. Please provide your contact information: Telephone No. Cell Phone No. email address Question Title * 3. Please provide speaker bio. Question Title * 4. Please select the topic you propose to speak about Governance, Risk and Controls Governance, Risk and Controls - IT Emerging Issues Emerging Issues - IT Government Government - IT Compliance Compliance - IT Audit Fundamentals Audit Fundamentals - IT Industry Specific - Banking/Finance Industry Specific - Legal Industry Specific - Retail Industry Specific - Manufacturing Industry Specific - Medical Industry Specific - other Other (please specify) Question Title * 5. Provide your title for your proposed presentation Question Title * 6. Provide 3 objectives for your proposed presentation Question Title * 7. List speaking events you have participated Question Title * 8. Are you a member of IIA? Yes No Next