NTA Member Solution Talks Application

Member Solutions Talks Information Fact Sheet

Contact Information: *This question is required.

Name
Company Name
Address
Office/Suite/Room
City

State/Province
Country
Telephone
Email

Membership category: *This question is required.

Please enter an 'other' value for this selection.

What is the main idea and/or basic outline for your talk? Be sure to identify how it fits the theme. *This question is required.

Please explain how your presentation will have relevance to all membership categories. *This question is required.

Links to any blogs, websites, books, articles, videos, previous or current speaking engagements, or anything that will help the Education Advisory Group better understand who you are, and your talk. *This question is required.

Please provide a brief biography. *This question is required.

Do you have any audio/visual requirements? (Please select all that apply)

PowerPoint Presentation
Streaming video
DVD video
Showing a website
Screen-sharing from a mobile device (iPad, iPhone, Android, etc.)
Other, please describe Please enter an 'other' value for this selection. * This question is required.

Are you currently registered for Travel Exchange? *This question is required.

You may attach a professional headshot photo to your application. (This is not required.)

File: {{filename}} delete

Terms

By signing and submitting this application, applicant agrees to participate, consents to the audio/video recording of their talk for future use by NTA, as well as presentation of the content of their talk/presentation in any NTA media/publication. Applicant agrees to attend Travel Exchange at their expense and understands no compensation or reimbursements will be made for any expenses incurred as it relates to the NTA Member Solution Talks.

Additionally, I certify that the information provided and presented is my own and does not infringe on the trademark, copyright or work of another individual or entity.

By signing and submitting, you are agreeing the terms stated above.

Clear

Signature of