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2018 AHA Leadership Summit Presentation Proposals

Speaking proposals are due December 1, 2017. Our design process will occur throughout the winter and we will contact you in March 2018 to notify you of our decisions.

You must hit "Submit" at the end of the form in order for your presentation submission to be transmitted. You will receive an e-mail confirmation once the information has been successfully submitted.

Please note: You will not be able to return to edit this form later. We suggest completing and saving all required information in a Word document and then cutting and pasting into this online form.

If you have any questions about the submission form, please contact Connie Lang at clang@aha.org.

Session Title *
Session Summary
Please provide a detailed summary of the session including a description of its focus and participant learning objectives.

While there is no official word limit for this summary, we suggest keeping it under 500 words. *
Please explain how this session is targeted toward to a senior executive level audience.

While there is no official word limit for this section, we suggest keeping it under 500 words. *
Select a content area: *
Responding to the Power of Consumerism in Health Care Integrating Workforce and Strategy for Organizational Transformation Driving Delivery System Change through Innovation Enhancing the Value and Affordability of Health Care Quality and Safety Improvements for Optimal Performance Leveraging Technology and Data Analytics in an Integrated System of Care Advancing Well Being Strategies for Achieving Governance Excellence
Main Contact Name * Title First Last Suffix
Main Contact Title *
Main Contact Organization *
Main Contact Email *
Main Contact Phone Number * ### - ### - ####
Speaker One Name * Title First Last Suffix
Speaker One Title *
Speaker One Organization *
Speaker One Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Speaker One Email *
Speaker One Phone Number * ### - ### - ####
Brief Bio for Speaker One *
Maximum of 500 words. Currently Used: 0 words.
Speaker One Speaking References: Please include information on any conferences/meetings/events where the speaker has spoken in the past, as well as contact information for people who can vouch for the speaker's content knowledge and presentation abilities at those events. *
Maximum of 500 words. Currently Used: 0 words.
Provide a brief description of Speaker One's organization (bed size, services, etc) *
Maximum of 500 words. Currently Used: 0 words.
Do you have additional speakers? *

If you select "Yes" you will be prompted to add additional speakers below.
Speaker Two Name * Title First Last Suffix
Speaker Two Title *
Speaker Two Organization *
Speaker Two Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Speaker Two Email *
Speaker Two Phone * ### - ### - ####
Brief Bio for Speaker Two *
Maximum of 500 words. Currently Used: 0 words.
Speaker Two Speaking References: Please include information on any conferences/meetings/events where the speaker has spoken in the past, as well as contact information for people who can vouch for the speaker's content knowledge and presentation abilities at those events. *
Maximum of 500 words. Currently Used: 0 words.
Provide a brief description of Speaker Two's organization (bed size, services, etc) *
Maximum of 500 words. Currently Used: 0 words.
Do you have an additional speaker?

If you have more than 3 speakers, please enter the first 3 speakers information on this form and e-mail any additional speakers' information, along with the session title, to clang@aha.org.
Speaker Three Name * Title First Last Suffix
Speaker Three Title *
Speaker Three Organization *
Speaker Three Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Speaker Three Email *
Speaker Three Phone * ### - ### - ####
Brief Bio for Speaker Three *
Maximum of 500 words. Currently Used: 0 words.
Provide BOTH speaking references and a brief description of Speaker Three's organization in the box below. *
Maximum of 500 words. Currently Used: 0 words.
By submitting a proposal to present at the AHA Leadership Summit, you are permitting AHA to use your name, voice, likeness and biographic information in connection with the creation, use and distribution and other related educational purposes that could include use on the World Wide Web. Additionally you warrant that the presentation and any written or verbal material you submit are original, that their publication will not infringe on the rights of others, and that you have full power to grant this license. If your presentation or written materials require permission for use, you have obtained a written permission from the copyright proprietor.

By participating in the Summit, you grant to AHA and its assignees and licensees a perpetual, royalty-free worldwide license to use, copy, modify, publicly display, publicly perform, broadcast and distribute in any format, including without limitation via the Internet the materials and your presentation of the materials.

The proposal submitter agrees to respect AHA’s policy of no selling of services, products, books, or future consulting assignments as part of the presentation to preserve the integrity of the educational experience.

All selected presenters will be responsible for all of their own meeting expenses, including travel, non-conference meals, and hotel accommodations. A complimentary conference registration will be provided to accepted presenters.

The proposal submitter understands and consents to photographs being taken onsite at the conference for future advertising and promotional purposes. *
I/We agree
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