ML24089A181: Difference between revisions

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{{#Wiki_filter:NRC FORM 1105                                                                             U.S. NUCLEAR REGULATORY COMMISSION (11-21-2022)
{{#Wiki_filter:NRC FORM 1105 U.S. NUCLEAR REGULATORY COMMISSION (11-21-2022)
RIC SPEAKER CONFIRMATION FORM
RIC SPEAKER CONFIRMATION FORM


Session Information (Session Chair or Coordinator to Complete):
Session Information (Session Chair or Coordinator to Complete):


Session Date                       Time of Session (7:00, etc.)   Session Number
Session Date Time of Session (7:00, etc.) Session Number


Session Title
Session Title


Name of Session Chair         Phone Number of Session Chair       E-mail Address of Session Chair
Name of Session Chair Phone Number of Session Chair E-mail Address of Session Chair


Name of Session Coordinator   Phone Number of Session Coordinator E-mail Address of Session Coordinator
Name of Session Coordinator Phone Number of Session Coordinator E-mail Address of Session Coordinator


Speaker Confirmation Information (Speaker to Complete):
Speaker Confirmation Information (Speaker to Complete):
Please TYPE the requested information below. Please refrain from using abbreviations and ensure that acronyms are spelled out.
Please TYPE the requested information below. Please refrain from using abbreviations and ensure that acronyms are spelled out.
Applicable information will be used for the purpose of populating the on-line conference program.
Applicable information will be used for the purpose of populating the on-line conference program.
Speaker's Full Name                     Speaker's Full Position Title           Speaker's Organization Name
Speaker's Full Name Speaker's Full Position Title Speaker's Organization Name


Speaker's Business Mailing Address (City, State & Zip code)Speaker's Business Telephone NumberSpeaker's Business E-mail Address
Speaker's Business Mailing Address (City, State & Zip code)Speaker's Business Telephone NumberSpeaker's Business E-mail Address
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Speaker Biographical Information (Speaker to Complete):
Speaker Biographical Information (Speaker to Complete):
Please provide a short biography in narrative form below. The information will be used for introductions at the conference and will be posted on the RIC public website.
Please provide a short biography in narrative form below. The information will be used for introductions at the conference and will be posted on the RIC public website.


Date Submitted:                                           Instructions to Coordinators:
Date Submitted: Instructions to Coordinators:
(MM/DD/YYYY)                       Please save form and submit by uploading to the RIC Tool.
(MM/DD/YYYY) Please save form and submit by uploading to the RIC Tool.


NRC Form 1105 (11-21-2022)                                                                                     Page 1 of 1}}
NRC Form 1105 (11-21-2022) Page 1 of 1}}

Revision as of 18:55, 4 October 2024

RIC 2024 NRC 1105 - Speaker Information Form_TH17_Prioleau
ML24089A181
Person / Time
Issue date: 01/26/2024
From: Mcellis B
NRC/NSIR/DPR/CB
To:
References
2024 RIC TH17
Download: ML24089A181 (1)


Text

NRC FORM 1105 U.S. NUCLEAR REGULATORY COMMISSION (11-21-2022)

RIC SPEAKER CONFIRMATION FORM

Session Information (Session Chair or Coordinator to Complete):

Session Date Time of Session (7:00, etc.) Session Number

Session Title

Name of Session Chair Phone Number of Session Chair E-mail Address of Session Chair

Name of Session Coordinator Phone Number of Session Coordinator E-mail Address of Session Coordinator

Speaker Confirmation Information (Speaker to Complete):

Please TYPE the requested information below. Please refrain from using abbreviations and ensure that acronyms are spelled out.

Applicable information will be used for the purpose of populating the on-line conference program.

Speaker's Full Name Speaker's Full Position Title Speaker's Organization Name

Speaker's Business Mailing Address (City, State & Zip code)Speaker's Business Telephone NumberSpeaker's Business E-mail Address

Speaker Presentation Information (Speaker to Complete):

Proposed Presentation Title

Speaker Biographical Information (Speaker to Complete):

Please provide a short biography in narrative form below. The information will be used for introductions at the conference and will be posted on the RIC public website.

Date Submitted: Instructions to Coordinators:

(MM/DD/YYYY) Please save form and submit by uploading to the RIC Tool.

NRC Form 1105 (11-21-2022) Page 1 of 1