sample project proposal
2010 Annual HIMSS Conference
Sample Proposal Form
This form is to provide you with an example of a completed submission form. In order to not unduly influence the proposals submitted, the information in this sample proposal will be used only to describe the type/ format of information we ask you to submit.
Submitter
*Required fields for submitter contact information
*Submitter First Name: Adam
Submitter Middle Initial: I
*Submitter Last Name: Bazer
Organization: HIMSS
Email: abazer@himss.org
Day time Phone: (312)915-9257
Primary Speaker
Speaker Information - list the speaker's name, credentials, title, and organization exactly as you wish it to appear in the program.
*Required fields for speaker contact information
*Primary Speaker First Name: Adam
Primary Speaker Middle Initial: I
*Primary Speaker Last Name: Bazer
Credentials: (i.e.: PhD, RN, etc.)
*Title: Manager, North America
*Organization: HIMSS
*Address 1: 230 E. Ohio Ave
Address 2: Ste. 500
*City: Chicago
*State: IL
*Zip: 60601
Country: USA
*Email: abazer@himss.org
Upon acceptance, I would like the presentation attendees to contact me via email for inquiries regarding my session.
*Daytime Phone: 312-915-9257
Cell Phone: 312-***-****
HIMSS Member: x Yes No
Did you attend HIMSS 2008 in Orlando? Yes - I attended HIMSS08 in Orlando
How many previous HIMSS Annual Conference and Exhibitions have you attended?:
Professional Title: Management
Worksite: Non-Profit Organization
Principal Work Focus: Education
Length of Time in the Field (years): 4
Speaker QualificationsSpeaker Biography of your professional background. (100 word maximum)
Here is where one should include a 75-100 word bio sketch that can be used for marketing purposes.
Public Speaking Experience: Required if submitting for lecture or roundtable. Not required for E-Session submitters. List the most recent three presentations you have made at regional and national meetings. Identify speaking organization,
Sample Proposal Form
This form is to provide you with an example of a completed submission form. In order to not unduly influence the proposals submitted, the information in this sample proposal will be used only to describe the type/ format of information we ask you to submit.
Submitter
*Required fields for submitter contact information
*Submitter First Name: Adam
Submitter Middle Initial: I
*Submitter Last Name: Bazer
Organization: HIMSS
Email: abazer@himss.org
Day time Phone: (312)915-9257
Primary Speaker
Speaker Information - list the speaker's name, credentials, title, and organization exactly as you wish it to appear in the program.
*Required fields for speaker contact information
*Primary Speaker First Name: Adam
Primary Speaker Middle Initial: I
*Primary Speaker Last Name: Bazer
Credentials: (i.e.: PhD, RN, etc.)
*Title: Manager, North America
*Organization: HIMSS
*Address 1: 230 E. Ohio Ave
Address 2: Ste. 500
*City: Chicago
*State: IL
*Zip: 60601
Country: USA
*Email: abazer@himss.org
Upon acceptance, I would like the presentation attendees to contact me via email for inquiries regarding my session.
*Daytime Phone: 312-915-9257
Cell Phone: 312-***-****
HIMSS Member: x Yes No
Did you attend HIMSS 2008 in Orlando? Yes - I attended HIMSS08 in Orlando
How many previous HIMSS Annual Conference and Exhibitions have you attended?:
Professional Title: Management
Worksite: Non-Profit Organization
Principal Work Focus: Education
Length of Time in the Field (years): 4
Speaker QualificationsSpeaker Biography of your professional background. (100 word maximum)
Here is where one should include a 75-100 word bio sketch that can be used for marketing purposes.
Public Speaking Experience: Required if submitting for lecture or roundtable. Not required for E-Session submitters. List the most recent three presentations you have made at regional and national meetings. Identify speaking organization,