Contact Details

Email Address:

Mobile Number:

Company:

Please provide the name of the company nominating the presenter. If you are a presenter and do not work for a company enter N/A.

Proposal

Proposal type:

I am proposing a presenter to be provided by my company.I am proposing myself as a presenter.

Please clarify whether you are nominating a presenter that your company will provide, or if you are self-nominating as a presenter.

Session type:

CPD Session (45 minute lecture)Workshop (1.5 hour hands-on)*

*Please note use of the workshop facility is charged at $1999 for ADIA members and $3999 for non-members (charges ex GST).

Presenter's Email Address:

Presenter Mobile Number:

Presenter's Role:

Marketing and promotion

Marketing and Promotion:

Please outline the marketing capabilities of this presenter eg: online presence, podcasts, international/national reputation, social channels and number of social media followers.

Presenter Bio (Max 60 words).:

Please include the presenter's qualifications (eg general dentist) and frame the bio in third person.

Would the speaker be able to shoot a 15-second video to promote the presentation on social media.:

YesNoNot sure

Does the speaker have any video they can share for advertising and promotional purposes?:

YesNoNot sure

Link to LinkedIn Profile:

Presentation title (Max 10 words):

Sessions without a title will not be considered. A catchy title is more likely to be selected to present, and will more likely attract attendees. The title may be truncated for advertising and promotional purposes.

Presentation Information

Presentation description (80 words):

Please describe the presentation, outlining the benefit to participants.

Learning objectives or sub-topics (Max 60 words):

Please list up to 3 learning objectives or sub-topics.

To be eligible for consideration, please confirm that you agree to the following:

I am authorised to submit this expression of interest.I understand that this presentation may not be selected for the CPD program.I understand that sessions must be educational and that brand promotion of products or services will be more appropriate for the Learning Labs programI understand the nominating company/presenter is responsible for all expenses incurred, including travel, accommodation etc.

To be eligible for consideration, please confirm that you agree to the following if this presentation is selected:

The presenter may be scheduled to make this presentation up to three times over the course of ADX Sydney..The presenter understands that the photograph, bio, presentation title and presentation description may be used by ADIA for marketing purposes.The presenter understands that this session may be video recorded and used by ADIA for educational and marketing purposes.The presenter must provide the Powerpoint presentation a week prior to the event as requested by ADIA to ensure smooth running of the event.The presenter must sign a Presenter Terms and Conditions form to confirm their presentation session/s.

Email Address