REQUESTFORPROPOSALSforPROFESSIONALCONFERENCESPEAKERS
PROPOSALINFORMATIONSHEETPleasecompletethisproposalinformationsheetandsubmitasignedcopywithyourproposalpackage.YourproposalpackageshouldincludetheinformationrequestedinSectionV,itemsBthroughG.
ProposedPresenterInformation
Name________________________________________________________________________________
Title(ifapplicable) _____________________________________________________________________
CompanyorOrganization(ifapplicable)____________________________________________________
EmailAddress_________________________________________________________________________
MailingAddress _______________________________________________________________________
City ___________________________________ State ________________ ZIP__________________
Isthis home work other(pleasespecify)_________________________________________
Daytimephonenumber______________________ Mobilephonenumber______________________ProposalPreparerInformationIfthisproposalispreparedbysomeoneotherthantheproposedpresenter,pleaseprovidehis/hercontactinformationbelow.Otherwise,leavethissectionblank.
PreparerName________________________________________________________________________
EmailAddress_________________________________________________________________________
Daytimephonenumber______________________ Mobilephonenumber______________________
StatementofUnderstandingBysigningthisproposalinformationsheet,IacknowledgethatifmyproposalisacceptedbytheVirginiaSHRMStateConferenceProgramCommittee,IwillprovideprofessionalconferencespeakingservicesprobonopublicoorasotherwisespecifiedinthisproposalforthegoodoftheHumanResourcesManagementprofessionandinsupportofthegoalsandobjectivesoftheConference.IagreetoindemnifyandholdVIRGINIASHRMSTATECOUNCILharmlessfromanyliabilityandagreetorefrainfromusinganyportionofmypresentationasaplatformtopromoteproductsorservices.
__________________________________________ ________________________________________SignatureofProposedPresenter Date