ML15345A326
| ML15345A326 | |
| Person / Time | |
|---|---|
| Issue date: | 12/14/2015 |
| From: | Diane Jackson NRC/NRO/DARR |
| To: | Bell R Nuclear Energy Institute |
| Malave-Velez Y | |
| Shared Package | |
| ML15345A300 | List: |
| References | |
| Download: ML15345A326 (3) | |
Text
SPEAKER INFORMATION AND CONFIRMATION FORM Session Information (Session Chair or Coordinator to Complete):
Session Date, and Time: March 9, 2016 form 10:30am to 12:00pm Session Number and
Title:
W12 - Domestic and International Efforts to Prepare for Advanced and Small Modular Reactors Session Chair: Deborah Jackson Session Coordinator: Yanely Malave Speaker Confirmation Information (Speaker to Complete):
TYPE or PRINT to ensure the information provided is legible. Please spell out acronyms and refrain from using abbreviations. The information you provide below will be included in the online conference program and in the printed conference program.
CONTACT INFORMATION:
- FULL NAME:
- FULL POSITION TITLE:
- FULL ORGANIZATION NAME:
o BUSINESS MAILING ADDRESS:
o BUSINESS TELEPHONE NUMBER:
o BUSINESS E-MAIL ADDRESS:
Speaker Presentation Information (Speaker to Complete):
Proposed Presentation Title Please complete form and return to your Session Coordinator by December 18, 2015
Please provide a short biography in narrative form using MSWord format. The bio will be used for your introduction at the conference and for posting on the RIC website.
SPEAKER BIOGRAPHICAL INFORMATION
EXTERNAL SPEAKER AGREEMENT FORM Speaker information and slide presentations are included in RIC conference materials and on the RIC public web site. Conference materials are available to the general public in advance of the conference and on site at the conference facility.
Your consent is required for NRC to make your information public in RIC conference materials and on the RIC public web site. To grant NRC permission, please sign Agreement #1 below.
If you do NOT wish to grant NRC permission to make your information public, please sign Agreement #2 below.
AGREEMENT #1 (Agree your information can be made public)
I accept the invitation to be a speaker at the 2015 RIC, and grant NRC permission to:
- Photograph, videotape, audiotape and post my presentation slides on the public website (Internet); and
- Use the aforementioned images in educational and information activities without compensation.
Please Sign Speaker Agreement Below (signature required):
Printed Name Organization Signature Date AGREEMENT #2 (Do NOT agree your information can be made public)
I accept the invitation to be a speaker at the RIC, but, I do NOT grant NRC permission to make my information public. I will inform my Session Coordinator of my request.
Please Sign Speaker Agreement Below (signature required):
Printed Name Organization Signature Date Please complete form and return to your Session Coordinator by December 18, 2015