Call for Speakers Application

You must complete this application in one sitting. Progress cannot be saved once you begin.
  • You can propose up to two sessions in this application. See Requirements
  • To have your proposal(s) considered, you must do both of the following:
    • Complete all required fields
    • Submit this application
  • By submitting this application, you agree to all the requirements outlined in the Speaker Commitment and Conditions.

Submission deadline: September 12, 2025

  • Speaker Contact Information
  • Speaker Bio
  • Speaker Availability
  • Number of Proposals
  • Proposal #1
  • Proposal #2
  • Comments
Indicates required field

Speaker Contact Information

Full name
Enter your name as you would like it listed on the agenda. You will be considered the “lead” speaker on this proposal and all correspondence will be directed to you.
Prefix
(e.g. J.D., M.D., M.S., Ph.D., LIMHP, etc)
Use format: xxx-xxx-xxxx

Speaker Bio

300-word limit. 

  • Please include your current work position(s), educational background, any relevant past life/work experience, as well as any special certification/licenses.
  • Please structure your response in paragraph format or a series of complete sentences, rather than a list.

Speaker Availability

Speaking Availability

The 2026 NYCI is tentatively scheduled to offer six concurrent breakout sessions with 10-12 time slots each session. Please check all time slots that you are AVAILABLE to speak. This information will be used to assign your speaking date and time if your proposal is accepted.    
Are you willing to present your proposal(s) more than once?
Some sessions may be asked to be presented more than once during the conference. If you indicate you are willing, then the conference coordinator may reach out later to confirm that it will be a repeated session. 

Number of Proposals

How many sessions are you proposing?

Proposal #1

Enter the title of your session as you would like it to appear on the agenda. You will have limited opportunity to change it later, if your proposal is accepted.
250-word limit. Enter this description as you would like it to appear on the agenda. You will have limited opportunity to change it later, if your proposal is accepted.

Please list the main learning objective(s). 

  • You must list at least one objective. 
  • Enter one objective on each box. 
  • To add more objectives: Use the + button on the right of the box OR the green ADD button
more items
Audience Level
Select which audience level applies to your session.
Attendee has minimal or no prior knowledge of the topic.
Attendee has some prior knowledge/experience with the topic.
Attendee has significant or advanced knowledge/experience with the topic.
Intended Audience
Please select ALL that apply for whom this session is designed to inform.
Which of the following topic areas does this session satisfy?
Please select all that apply:
A computer WILL NOT be provided in the breakout rooms. Do you have the ability to provide your own laptop for the session?
Special Room Accommodations
A breakout room will include one screen and projector, a slide clicker, two microphones (one wired and one lavalier), internet access, and chairs set up theater style without tables.
Will you need special room accommodations?

Please select “Yes” if you need additional equipment (e.g. a DVD player or easel) or other accommodations (e.g. round tables for hands-on activities or to limit the number of attendees at your session). Otherwise, select “no.”

If proposal is accepted, we will inform you if we can accommodate your request or not.
Co-speakers
Will you have co-speaker(s) for Proposal #1?
You can add up to 5 co-speakers.
Enter co-presenter details
Prefix
(e.g. J.D., M.D., M.S., Ph.D., LIMHP, etc)

Proposal #2

Enter the title of your session as you would like it to appear on the agenda. You will have limited opportunity to change it later, if your proposal is accepted.
250-word limit. Enter this description as you would like it to appear on the agenda. You will have limited opportunity to change it later, if your proposal is accepted

Please list the main learning objective(s). 

  • You must list at least one objective. 
  • Enter one objective on each box. 
  • To add more objectives: Use the + button on the right of the box OR the green ADD button
more items
Audience Level
Select which audience level applies to your session.
Attendee has minimal or no prior knowledge of the topic.
Attendee has some prior knowledge/experience with the topic.
Attendee has significant or advanced knowledge/experience with the topic.
Intended Audience
Please select ALL that apply for whom this session is designed to inform.
Which of the following topic areas does this session satisfy?
Please select all that apply:
A computer WILL NOT be provided in the breakout rooms. Do you have the ability to provide your own laptop for the session?
Special Room Accommodations
A breakout room will include one screen and projector, a slide clicker, two microphones (one wired and one lavalier), internet access, and chairs set up theater style without tables.
Will you need special room accommodations?
Please select “Yes” if you need additional equipment (e.g. a DVD player or easel) or other accommodations (e.g. round tables for hands-on activities or to limit the number of attendees at your session). Otherwise, select “no.”
If proposal is accepted, we will inform you if we can accommodate your request or not.
Co-speakers
Will you have co-speakers for Proposal #2?
You can add up to 5 co-speakers.
Enter co-presenter details
Prefix
(e.g. J.D., M.D., M.S., Ph.D., LIMHP, etc)

Comments