2025 Speaker Proposal - Nevada Health Care Association

Today's Date*

SPEAKER

Speaker's Name*

First Last

Coordinator/ Manager's Name

If other than speaker

First Last

Primary Contact Email*

Speaker or Coordinator/ Manager

Primary Phone*

Organization / Company*

Event Participation*

2025 In-Person Fall Convention (1 hour)
2025 In-Person Event (1-3 hours)
2025 Webinar Training (1-3 hours)

Speaker Experience*

Less than 5 Years
5 - 10 Years
More than 10 years

Experience details

Please provide a summary on experience

PRESENTATION

Presentation Title*

Topic Audience*

Skilled Nursing
Assisted Living
Both

Presentation Format*

Select all that are applicable

In-Person
Virtual

Presentation Category*

Select all applicable categories

Clinical
Ethics
HR / Staffing
Leadership
Motivational
Pharmaceutical
Regulatory
Safety
Wound Care

Presentation Length*

Select the closes time frame

TOPIC Amplifying Remarks

Topic Summary*

Topic Objectives*

Provide at least 3 objectives for this session

Available On-line Videos for review

Please list any URLs that you have for marketing videos, example trailers or full length videos I can review. I'm looking for a short sample of your presentation style. If none exist, please type NONE in the text field.

COMPENSATION

Speaker Fee(s)*

No fee is required
Honorarium is requested

Would you consider a discounted fee?*

Yes
No

In-Person Honorarium*

Indicate cost of honorarium fee, if you are offering multiple fees, indicate any subsequent fee in the remarks block below

Virtual Honorarium

Place subsequent honorarium fee

Transportation Reimbursement Requirements*

We offer a flat rate travel expense of $500, along with a single night stay at the venue. Indicate if you require any of the following.

Hotel Accommodations
Flat Rate Expense
Not Applicable

Additional Comments