Chapter Meeting Speaker Form

Welcome and thank you for applying to be a speaker at one of our monthly Chapter Meetings. Please be sure to review the information on the Become a Speaker page on our website.
All fields must be completed in order for us to consider your application.



Speaker Information


FULL NAME(*)

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COMPANY(*)

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ADDRESS(*)

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CITY(*)

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STATE(*)

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ZIP(*)

enter a valid zip code

PHONE (xxx-xxx-xxxx)(*)

enter a valid phone number (123-456-7890)

EMAIL(*)

enter a valid email address

MEMBERSHIPS/CERTIFICATIONS

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Presentation Promotional Information



IMPORTANT! The following information will be included in promotional materials and marketing activities. Please be sure that it is complete and accurate.


SPEAKER'S BIO (*)

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PHOTO: Upload a hi-res image, which will be used in promotions.

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IMPORTANT: Please be sure your file is attached just before clicking the Submit button! If you miss any required fields the file will become unattached.

PRESENTATION TITLE: Provide a descriptive, engaging title that explains the benefit of your presentation.(*)

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PRESENTATION DESCRIPTION: Describe what attendees will learn in 150 words or less. (*)

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PRESENTATION OUTCOMES: List at least three objectives or learner outcomes. (*)

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PMI prides itself on providing educational value in the keynotes, trainings, seminars and workshops that we provide. To ensure our attendees receive maximum value, we ask our speakers to provide clear learning outcomes for their sessions. To assist you in writing these clearly defined outcomes, we invite you to read to the white paper: "Developing Clear Learning Outcomes and Objectives" which can be found at: http://www.thelearningmanager.com/pubdownloads/developing_clear_learning_outcomes_and_objectives.pdf.



Logistical Information



Chapter meetings are held on the third Tuesday of every month, except July and August. There is a keynote speaker and an educational speaker at every meeting.
You can check the Our Speakers web page to view open slots.
Please indicate your interest(s) below.


PRESENTATION TYPE(S)(*)


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PREFERRED MEETING DATE #1(*)

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PREFERRED MEETING DATE #2

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Please enter the month/year of your preferred meeting dates above.

AV EQUIPMENT(*)

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A computer, mic, projector and screen are provided. Indicate if you need Internet access or flipcharts/markers. You are responsible for providing other equipment and materials including handouts.

MEAL PREFERENCE(*)


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Speaker Guidelines



We ask that you review and confirm that you agree with the following guidelines as a speaker at our Chapter meeting.

I understand and agree that as a presenter, I must:
>> Register and attend the meeting unless otherwise notified.
>> Provide and distribute my own handouts unless other arrangements are specifically agreed upon. NOTE: the Chapter will distribute your PPT presentation only to meeting registrants.
>> Not discuss fees or fee ranges during my presentation.
>> Adhere to the PMI Code of Ethics.
>> Not receive royalties or other compensation in connection with any sale or use of products during the presentation or speaking event (handouts with contact information for subsequent follow-up sales activity is permitted).
>> Refrain from mentioning, selling or promoting any products or services that would result in financial gain for me or my companies unless I have the expressed permission from the Portland Chapter of PMI. Products and services include, but are not limited to, books, tapes, coaching, consulting, special reports, boot camps, CDs, tele-seminars, webinars and subscriptions.


Contact Me re: Sales permission

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If your presentation is specifically designed to discuss the development and/or sales of products or services, you are allowed to use your products, services and techniques as examples. You will need to secure permission from the Dir of Speaker Acquisition and will be asked to inform the audience that you have secured such permission so our attendees understand that you not violating these guidelines. Please check this box if you need us to contact you so that you may secure such permission.

I have read and agree to abide by the PMI Portland Chapter Speaker Guidelines. This is my electronic signature.(*)

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Be sure your photo is still uploaded!



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