akGSHC Call for Speakers

Call for Presenters for May 18-20, 2022 Alaska Governor's Conference on Safety & Health

Please complete all information about the main presenter. At the end of this form, you will be asked to attach a short descriptive proposal for your one-hour presentation (inclusive of Q&A) before completing this process. If you are presenting solo, skip the Co-Presenter section (go to Question 8). However, if you will be co-presenting, complete the questions describing that person.

If you are NOT submitting a proposal, skip to Question 13 by pressing the NEXT button 3 times to reach the final page. Marking this question will result in no further reminders of this speaking opportunity.

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* 1. Presenter’s Information

First Name:

Surname:

Job Title:

Email:

Mobile Phone:

Address:

State/Province:

Zip:

Designations/Certifications:

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* 2. Presenter will accept text messages about conference and schedule at the following number: (most messages will be at end of March, first week of April)

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* 3. Does presenter have use of Social Media? (Enter your address for each)

Face Book

Twitter

Instagram

Other