Form Test

Event / Speaker Registration Form

Section A - EVENT INFORMATION

Event Type | Programs [Check the program below]

Morning (virtual; between 7:00 am to 10:00 am)

Evening (virtual; between 5:00 pm to 9:00 pm)

Flagship (in-person; between 5:30 pm to 9:00 pm)

Industry Networking (in-person; between 5:30 pm to 9:00 pm)

Multi-Chapter (virtual; between 4:00 pm to 8:00 pm)

PDUs | PDUs categories: Education and Giving Back to the Profession

No

Yes

Number of PDUs

Business Acumen (formerly Strategic and Business Management)

Power Skills (formerly Leadership)

Ways of Working (formerly Technical)

Event Date & Time (in Pacifc Time Time Zone)

Month DD, YYYY

Start Time

End Time

Event Title (less than 50 characters)

Please provide a title for your presentation. Please be succinct but also descriptive. Long titles may be modified.

Event Description (less than 300 words)

Please provide the detailed description of your presentation.

Event Learning Objective

Please provide learning objectives for your presentation.

Section B - SPEAKER INFORMATION

Speaker Name

LinkedIn Profile URL

Speaker Professional Biography

Speaker Contact Information (cell, email, social media, website, YouTube, etc.)

Are you listed in the PMI Speakers Bureau?

Yes

No

Have you spoken at any other PMI Chapters?

Yes

Which PMI Chapters?

No

Speaker's Fee | PMI-LA is a non-profit organization, and we strive to procure quality speakers at no cost. However, we sometimes have opportunities for speakers to deliver a virtual Multi-Chapter Meeting virtually to share in the burden of a small speaker’s fees with other PMI Chapters to provide benefits to more members.

If you have an associated speaker's fee, please list it here.

Please email your professional headshot photo in JPG format and any other supporting documents to PROGRAMS-Speakers@pmi-la.org. Please note that any images provided will be used in Marketing the event. Please avoid copyrighted materials.