Employee Benefit Planning Association (EBPA)

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Speaker Direct Form

Event Information

* Please indicate event(s) type you are submitting for: please check all that apply.

In-person Presentation
Webinar
Employee Benefits Summit
Other (please specify below)

Other:

* Date(s) you are confirmed to present: separate multiple dates and times with a comma.

Presenter's Information

* Presenters name, title and company name: If multiple speakers are presenting, please separate speaker names with a semi colon.

* Professional Designation/Certification:

* Phone : If multiple speakers are presenting, please separate phone numbers with a semi colon.

* Email: If multiple speakers are presenting, please separate emails with a semi colon.

* Presenter's Short Biography Include a short bio you would like used as a speaker introduction - 2000 character limit

* Attach Presenter's Head Shot JPG or PNG 480x640 * If there are multiple speakers, please attach additional headshot using the links below.

Speaker Headshot

Presentation Information

* Program Session Title:

Has this presentation previously been approved for HRCI or SHRM certification credit?

Yes
No
Not sure
N/A

If yes, please indicate HRCI Number and Date Presented

What type of credit are you seeking for this program?

* Marketing Statement: A paragraph describing what attendees will learn by attending this program, including at least 3 learning objectives - 2000 character limit

EBPA follows the industry standard of capturing educational content via audio and/or video. Your presentation will be recorded and may be made available on the EBPA Website

Quick Links

Speaker Direct Form

Event Information

Presenter's Information

Presentation Information

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