CHCA Presenter & Training Information (Internal)

Name: Colorado Health Care Association
Address: 4100 E. Mississippi Ave. Suite 925, Glendale, CO, 80246
Telephone: 303-861-8228

Speaker Name*
Speaker Title
Speaker Company*
Best Contact Email for Speaker*
Best Phone Number for Speaker*
Speaker Honorarium
Speaker Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

For the confirmation letter
Webinar Title*
Webinar Date*
Webinar Time*
Please note all webinars will be held in MST
Due By Dates
Please add when you would like confirmation letters sent, date to add to calendar, date to send marketing material.
Speaker Timezone*
Webinar Duration*
How long will your presentation be?
Target Audience*
Synopsis of Webinar*
Please include any summaries/bullet points you would like included on the brochure
Program Material
Max. file size: 21 MB.
Please upload any program material that will be used during the presentation.
Webinar Practice Demonstration*
CHCA asks that all speakers presenting a webinar do a 20 minute run through regarding how our webinars operate to make sure our speakers feel comfortable with the software. Please choose a date and time between now and the date of the webinar for the run through
During the program, would you like the questions submitted through the Q/A function read out as they are received, or saved for the end?*
Please submit a biography for the speaker(s)*
Please Provide the Name & Contact Information of Any Additional Presenters

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