Island Prosperity

Premier's Speaker Series - Online Application

Applicant's Information

Full name of applicant:

Full name of organization (if applicable):

Applicant's title/position:

Full mailing address of applicant/organization:

Full civic address of applicant/organization (if different from mailing address):

Phone number:

Cell phone number (optional)

Fax number:

Email address:

Contact person (if different from above): Include name, title, email and phone number

Proposed Agenda, Experience and Strategic Fit

The content and depth of the proposal will be at the applicant’s discretion, but should include within, at a minimum, the profile information request presented below:

Identify the speaker(s) and include their qualifications.

Please provide a title and brief summary including the objectives or purpose of inviting the guest speaker, deliverables, distribution approach and the target audience. (This should capture the essence of the project). (250 words or less)

Include a proposed agenda. This should include proposed dates and the location of the event.

Include a budget. This should outline total expenses related to the entire agenda and provide details on the source (i.e., grants, cash and in-kind contribution, etc.) and use (i.e., travel, accommodations, honorariums, etc.) of funds.

Identify how the proposed agenda fits within the bio-science (including agriculture and fisheries), information technology, aerospace, or renewable energy sectors. Provide a summary as to how you believe this individual will advance the knowledge or activities on Prince Edward Island in one or any of the above strategic sectors. (250 words or less)

Please provide an up-to-date CV or resumé for the principal applicant(s) and list all other individuals involved in the delivery of the proposed agenda; include a history of the organization, if applicable. Be sure to include relevant education, training, credentials, associations, work experience, industry experience, and all other pertinent information.

Peer Review Committe Input (optional)

Reviewer 1

Name

Address

Phone Number

E-mail

Area(s) of Expertise

Reviewer 2

Name

Address

Phone Number

E-mail