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Webinar Series - Speaker Application Form
Thank you for considering sharing your experience and knowledge during a talk for our GGMC Educational Webinar Series!
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* Indicates required question
Email
*
Your email
First name and Last name
*
Your answer
Are you a member of IHCC or G2MC?
Please note: Priority may be given to G2MC and IHCC members, partners, funders, or actively engaged peers
*
Member of G2MC
Member of IHCC (If a member of IHCC, please write the name of the cohort you represent in the "Other" field below)
Neither a member of G2MC nor IHCC
Other:
Required
What month(s) would you be available to present? (Select all that apply)
*
June 2023
July 2023
August 2023
September 2023
October 2023
November 2023
December 2023
Other:
Required
What is your time zone?
*
Your answer
Title of the talk you would like to present
*
Your answer
Short summary of the talk you would like to present (Note that the duration of the talk should be 30 minutes maximum. There will be 10-15 more minutes for Q&As after the talk)
*
Your answer
Your biography (max 150 words)
*
Your answer
Your contact information to share with the audience (and website, YouTube, etc)
*
Your answer
Any other links you want to share with the audience (website, LinkedIn, publications, books, etc)
Your answer
We would need a headshot for promotional purpose (website, announcements), please provide a link where we can find one, or send one by email to
lelhadri@g2mc.org
.
Your answer
Do you accept having your talk recorded and the replay posted on the GGMC website?
*
Yes
No
Other:
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