HR Leadership Summit Form

HR LEADERSHIP SUMMIT FORM

Event Details

Summit Title:

Summit Dates: From to    Location:

Personal Information

Position Information

Full-time    Part-time    Contractor

Travel & Accommodation

Will travel be required? Yes No

Lodging requested? Yes No    Room preference:

Session Selection & Preferences

Please select sessions you plan to attend (select all that apply):

Plenary Sessions    Workshop A: Strategic Talent    Workshop B: Change Leadership

Leadership Lab    Networking Roundtables    Other

Professional Background

Provide details of recent employment. Attach additional pages if necessary.

Education

Professional References

Provide three professional references who can speak to leadership performance and professional conduct.

Emergency Contact & Health

Policy Acknowledgements & Authorizations

At-Will Employment: I acknowledge that my participation in the HR Leadership Summit is voluntary and that my employment status remains at-will. Nothing in the summit materials or participation constitutes a contract of employment or alters the at-will relationship.

Equal Opportunity: The organization prohibits discrimination and provides equal opportunity in all employment practices. Participation in this event will be administered in a manner consistent with applicable equal employment opportunity policies.

Confidentiality and Intellectual Property: I agree to keep confidential any proprietary or sensitive information disclosed during sessions that is designated as confidential. All materials distributed remain the intellectual property of the organization or presenters; I will not record, reproduce, or distribute such materials for commercial purposes without written authorization.

Code of Conduct: I will adhere to professional standards of conduct. Harassment, discrimination, or other behavior that undermines a safe and respectful environment may result in removal from the event and review under applicable disciplinary procedures.

Background and Reference Checks: By signing below I authorize the organization to contact my prior employers and listed references and to conduct background checks to the extent permitted by law for the purpose of validating information provided in this form and assessing suitability for participation in leadership programming.

Photo/Media Release: I consent to being photographed or recorded for internal training and record-keeping purposes    I do not consent

Expense Policy: Travel and lodging will be provided or reimbursed only where pre-approved. All reimbursements require itemized receipts and compliance with the organization's travel policy. Any personal expenses are the responsibility of the attendee.

Applicant Certification

By signing below I certify that all information provided on this form is true, complete, and accurate to the best of my knowledge. I understand that false statements may result in denial of participation or disciplinary action. I authorize the organization to verify any information provided, including contacting prior employers and references and conducting background checks in accordance with applicable law.

I further acknowledge that participation may require compliance with health and safety protocols and that I will notify the organizer of any changes to my availability or ability to participate.

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