Webinar Speaker Proposal Form

IHS staff will contact you should your proposal be a fit for the IHS webinar program. Please note that being an IHS webinar speaker is a volunteer opportunity. In addition to committing to the presentation of a live webinar, chosen speakers are also required to run through the entirety of their presentation twice before the live presentation.

Contact Information
First Name: *
Last Name: *
Credentials (ACA, BC-HIS, etc.):
Job Title: *
Company: *
Street Address: *
Street Address (2):
Mail Stop/P.O. Box:
City: *
State/Province: *
Zip/Postal Code: *
Country: *
Phone: *
E-mail: *
Company Website:
IHS Member I am not an IHS member but would like to join
Brief Biography: * Please provide a 3-5 sentence professional biography of the instructor(s) (200 word limit).

Presentation Information
Presentation Title: *  
*Abstract: * Please provide an abstract (limit 300 words) describing your presentation.

Learning Objectives: *
(learning outcomes, knowledge outcomes, key ideas) Please provide 3-5 brief bullet points describing what attendees will learn from your presentation. If selected to present, these may be used in marketing materials.

NOTE: Learner outcomes should complete the sentence: "After this seminar, participants will be able to…" Examples of measurable verbs would include but are not limited to" list, demonstrate, define, and apply.

Who is the target audience for this topic?

General Category:
* (check all that apply)

Practice Management
If other, please describe

Why is this topic important to this audience?
* Please provide any history, trends, examples that make this presentation vital to current hearing aid specialists.

Topic Area:
* (Check all that apply) Refer to the IHS approved categories of instruction.

Hearing Science
Audiometric Assessment
Audiometric Interpretation
Patient Information and History
Hearing Instrument Systems and Technology
Selecting Amplification Systems
Instrument Fitting Techniques
Office/Business Management
Sanitation Protocols
Ear Mold Impressions
Professional Communication
Non-Amplification Hearing Systems
Federal Regulation
Post Fitting Patient Care
Ethics/Legal Considerations
Marketing and Sales
If other, please describe

Have you presented this topic at other events? *
No Yes     If so, where and when?

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