Wellness Segment Submission Submission Form

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SAMPLE
Wellness Segment Submission Submission Form

Title (Maximum 90 characters)

Short Description (Maximum 400 words)

0 words

Outcomes (Maximum 500 words)

0 words

People entered here will be given access to this submission like the original submitter.

Your First Name

Last/Family Name

Your Email Address

Organization

2nd Organization

City

State/Province

Country

Professional Title

Primary Telephone

Type

Biography (Maximum 500 words)

0 words

Upload a photograph of this person (JPEG/PNG)

Please select your professional sector.

Please select your career level.

Student - Currently enrolled in an educational program, e.g. college, university, bootcamp, etc.

Intern - Currently working, with or without pay, to gain work experience.

Entrepreneur - Organizes and operates a business usually with considerable initiative or risk.

Professional - Jobs in this category typically (but not always) require professional degrees or certifications. This category includes roles like engineers, accountants, teachers, pilots, programmers, lawyers, programmers, and doctors.

Mid - These individuals serve at functional, line of business segment or branch levels and are responsible for directing and executing the day-to-day operational and, in some instances, directly supervising the activities of personnel. Examples of these kinds of managers are: first-line managers; team managers; unit managers; operations and production managers; branch managers; technical support managers; and brand or product managers.

Senior - Individuals in this category take direction from those in the Executive job category. The Senior job category includes managers at the group, regional, or divisional level of the organization. Examples of these Kinds of managers are: vice presidents and directors, Group, regional or divisional controllers

Executive - This category is reserved for the highest level within the organization. This level includes individuals who plan, direct, and formulate policies, they set the strategy, and they provide information to be approved by the board of directors. Some examples are the chief executive officer or the chief operating officer.

Have you previously won an Abie Award?

Yes

Are you a past GHC Scholar (Scholarship awarded from AnitaB.org)?

Yes

Briefly describe the person's key prior speaking experience. You may also provide a link to videos. (Maximum 600 characters)

0 chars

Number of years experience.

1-5

6-10

11-20

20+

Click here to view and sign the speaker agreement. Once you have finished, please acknowledge completion.

Complete

Do you give permission for your organization to be notified of your submission to the AnitaB.org CFP for internal reporting purposes?

yes

Your First Name

Last/Family Name

Your Email Address

Organization

2nd Organization

City

State/Province

Country

Professional Title

Primary Telephone

Type

Biography (Maximum 500 words)

0 words

Upload a photograph of this person (JPEG/PNG)

Please select your professional sector.

Please select your career level.

Student - Currently enrolled in an educational program, e.g. college, university, bootcamp, etc.

Intern - Currently working, with or without pay, to gain work experience.

Entrepreneur - Organizes and operates a business usually with considerable initiative or risk.

Have you previously won an Abie Award?

Yes

Are you a past GHC Scholar (Scholarship awarded from AnitaB.org)?

Yes

Briefly describe the person's key prior speaking experience. You may also provide a link to videos. (Maximum 600 characters)

0 chars

Number of years experience.

1-5

6-10

11-20

20+

Click here to view and sign the speaker agreement. Once you have finished, please acknowledge completion.

Complete

Do you give permission for your organization to be notified of your submission to the AnitaB.org CFP for internal reporting purposes?

yes

By checking this box, I hereby attest that all information in this submission is factually true and honestly presented.

Important Notes

When you submit the form, wait to see if any errors are reported. If errors are not fixed, it will not be counted as submitted.
When this submission has been received, a confirmation email will be sent to the submitter entered above. These emails should be kept as receipts. If they do not get this email, it is likely that the submission has not been received. They should verify that they can see it on their "My Submissions" page, and if not, resubmit. It is your responsibility to confirm that the submission has been received.
The submitter entered above can update this submission until submissions close.