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* 1. Name:

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* 2. Organization:

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* 3. Position/title:

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* 4. Presentation title:

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* 5. ATD competency area (choose competency area(s) that matches the  proposed topic most closely):

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* 6. Presentation description:

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* 7. Presentation objectives (list up to 5):

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* 8. Strategies to engage and involve audience:

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* 9. Experience with delivering presentations in a professional setting:

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* 10. List 3 professional references who observed/ participated in your presentation:

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* 11. Submit Youtube, Vimeo, or your website link with a video of you presenting (optional):

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* 12. Contact Info

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