SJCCF Speaker Proposal Forms

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Stevie JoEllie's Cancer Care Fund's Speaker Proposal Forms

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SJCCF Speaker Proposal Forms

  1. 1. Stevie JoEllie’s Cancer Care Fund’s Annual Thyroid Cancer Survivors Reunion and Celebration of Life Sept. 1st -8th 2012 Speaker/Presentation Application/Proposal Deadline for Submission: May 20, 2012 Email: steviejoelliescancercarefund@gmail.com Subject Line: Speaker ProposalPresenter NamePresenter Designation Page | 1Presenter Job TitleOrganization NameMailing AddressCityState / ProvidenceZip / Postal CodeCountryTelephoneFaxEmailWebsiteBlog Page 1 of 3
  2. 2. Stevie JoEllie’s Cancer Care Fund’s Annual Thyroid Cancer Survivors Reunion and Celebration of Life Sept. 1st -8th 2012 Speaker/Presentation Application/Proposal Deadline for Submission: May 20, 2012 Email: steviejoelliescancercarefund@gmail.com Subject Line: Speaker ProposalCo-Presenter NameCo-Presenter Designation Page | 2Co-Presenter Job TitlePresentation Title Session DescriptionNote: This description will beused for promotionalpurposes and should be acomplete and detaileddescription in 75 words orless that fully describes yourtopic content.Learning Objective 1Learning Objective 2Learning Objective 3 Page 2 of 3
  3. 3. Stevie JoEllie’s Cancer Care Fund’s Annual Thyroid Cancer Survivors Reunion and Celebration of Life Sept. 1st -8th 2012 Speaker/Presentation Application/Proposal Deadline for Submission: May 20, 2012 Email: steviejoelliescancercarefund@gmail.com Subject Line: Speaker Proposal Presentation Track Please choose the category that best fits your Select Only One presentation topic and target audience. Page | 3 Thyroid Cancer Patients ( ) Pediatric ( ) Adolescent ( ) Young Adult ( ) General Thyroid Cancer Survivors ( ) Pediatric ( ) Adolescent ( ) Young Adult ( ) General Caregivers and Loved Ones ( ) Pediatric ( ) Adolescent ( ) Young Adult ( ) General HealthCare Professionals ( ) Pediatric ( ) Adolescent ( ) Young Adult ( ) General Health and Wellness ( ) Pediatric ( ) Adolescent ( ) Young Adult ( ) GeneralPlease review the following SJCCF Speaker and Presenter Policies prior tosubmitting your presentation description:  Stevie JoEllie’s Cancer Care Fund does not pay for travel expenses or speaker fees.  Stevie JoEllie’s Cancer Care Fund requires that your presentation and materials be your own original work or have obtained any necessary copyright permissions.  Stevie JoEllie’s Cancer Care Fund does not allow sales pitches or self promotion in their presentations. All information is to be presented in a fair and balanced context. Content should be based upon a relevant topic, concept or idea, not a specific product or service.  Stevie JoEllie’s Cancer Care Fund requires that if your topic is selected, that all handout materials be submitted a minimum of 2 weeks before the conference.  Stevie JoEllie’s Cancer Care Fund asks that you register for the Event if you are planning on attending beyond your own session. Signature:______________________________________ Dated:________________________ Printed Name:__________________________________ Title:__________________________ Page 3 of 3

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