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| Session Submission Guidelines: |
| The 2011 Call for Sessions is CLOSED. Please do not submit sessions at this time as they cannot be included in the planning materials and will not be considered. |
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| ALL FIELDS MARKED WITH AN *ASTERISK ARE REQUIRED FOR FORM SUBMISSION |
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| Proposed Session Title* |
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| By the end of this session, participants will be able to...* |
| Please complete the above sentence with the learning objectives of this session. Sessions will also be evaluated on whether or not objectives were met. |
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| Summary of session* |
| Please include a summary of proposed session including a short description of content along with any pertinent information regarding teaching techniques, handouts or audio/visual enhancements. |
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| Desired level of expertise* |
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| Please Choose: Beginner, Intermediate, Advanced, General Interest. You MUST choose a session level. |
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| Session Focus* |
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| Sessions only be accepted at this time with a focus on Safety, Insurance or Leadership. Please Choose: Safety, Insurance, Leadership. You MUST submit a session focus. |
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| Proposed Speaker* |
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| Please note that individual speakers are selected on their merits rather than selecting companies to provide speakers for a session. This holds for all speakers submitted.
Please submit on behalf of the speaker and NOT a company. If speakers change companies/entities the individual is still responsible for speaking at the conference. |
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| Proposed Speaker Company and Contact Information* |
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| A telephone number or email address is required for all proposed speakers. |
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| Second Proposed Speaker |
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| Second Proposed Speaker Company and Contact Information |
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| Third Proposed Speaker |
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| Third Proposed Speaker Company and Contact Information |
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| Session Submitted By* |
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| Email address* |
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| Company* |
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| Address* |
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| You MUST provide a physical address to have your session considered for presentation at the 2008 Conference. |
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| City, State, Zip* |
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| Telephone Number* |
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| Would you like this session to be included in either the Novice or Leadership Track?* |
No
Yes - Leadership
Yes - Novice
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| Please indicate the amount of time you will need for your session* |
1 hour
1 hour 15 minutes
1 hour 30 minutes
2 hours
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| Has this session been presented at a conference other than PARMA in the last 18 months?* |
Yes
No
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| If yes, please list the other conference this session has been presented at. |
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| Suggested Moderator: |
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| If you have a suggestion for a moderator for this session, please include here. |
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| Suggested Moderator Company: |
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| Way to contact Suggested Moderator: |
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| Handout or Outline |
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| If you would like to include a handout or outline for consideration, submit here. |
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| Would you be interested in teaching a 101 class in one of the following areas: |
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| Workers' Compensation, Risk Management, Safety, Insurance, Liability or Professional Development/Leadership |
Yes
No
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| If yes, please indicate which topic you would be interested in presenting on. |
| Choose as many as you would like. |
| Workers' Compensation 101 |
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| Risk Management 101 |
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| Safety 101 |
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| Insurance 101 |
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| Liability 101 |
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| Leadership 101 |
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| If you would like a copy of this form emailed to you, please include your email address here: |
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