Expression of interest to present at 2022 ExNZ Conference ExNZ Conference 2022 (Formerly known as FitEX) is being held in Auckland on the 25-27th of November This expression of interest needs to contain full information on the session you are offering to be considered for presentation at the 2022 ExNZ Conference. The information contained in this expression of interest to present is used to determine session selection, timetables and equipment availability. Incomplete applications will limit your ability to request equipment later (as the schedule is designed to minimise conflicting equipment and room requests). We plan to have the 2022 event as a "Live Event". If there is an issue requiring us to not be able to host a live event, your session will automatically become virtual, If the session can not be virtual please click the "Session can not be virtual" option when submitting. There are additional requirements (currently) for entering NZ (pre departure forms) and the NZeTA for non NZ, AU passport holders. You may be required to complete these items to be able to travel - details on this will be provided to speakers selected to present. NOTE: Currently the NZ government require vaccination for NON NZ Citizens entering NZ - this may change over time so we are asking your status so that if things change we can consider your application. Unfortunately this us outside the control of ExerciseNZ. Name (legal name for use on Airline tickets etc)(Required) First Last Preferred Name (for use in marketing etc) Email(Required) Enter Email Confirm Email Mobile Phone Number(Required)If no mobile please enter a land line number hereAre you presenting on behalf of an organisation?(Required)YesNoThis means your session would be listed as sponsored and the organisation you are presenting for would cover your travel, accommodation and other costs while at the event. In exchange they are listed as the session sponsor. Please advise us of the name of the sponsoring organisation: Have you presented at the FitEx Conference before?(Required)YesNoVaccination Status (anyone traveling from overseas) - The NZ government currently limits travel for NON Citizens to those who are vaccinated only (this policy will be likely to change over time) and we would like to consider all applications based on rules at the time of selection (rather than exclude, while the government refines it's policies) I live in NZ so this is not applicable to me I am fully vaccinated I have a medical exemption to vaccination and will apply for an exemption for travel to NZ. I am not currently vaccinated - but will become vaccinated if it is required to travel to NZ. I have chosen to not be vaccinated - so understand I can only be selected as a speaker if govt policy changes in advance of speaker selections Previous Experience presenting at similar events: (please include details on the session and conference)(Required)References who can confirm your suitability as a presenter (include email and phone numbers where possible)(Required)How many sessions would you like to submit for consideration? Max 3(Required)123I have other sessions that I could present in addition to ones I am submitting as part of this application(Required)YesNoPlease list titles or broad areas that you could offer sessions for(Required)Session 1 Title:(Required) Session 1: This session can be presentedLive onlyVirtually if requiredSession 1: Session Description(Required)Session 1: Learning Outcomes (200 words Max - please use bulletpoints)(Required)Session 1: Technical Level you are pitching the session at(Required)NoviceIntermediateAdvancedSession 1: What prior experience would the attendees require?(Required)NoviceIntermediateAdvancedSession 1: Have you presented this session (or something very similar) at a FitEX Conference before?(Required)YesNoWhat year(s) did you present this session? Session 1: Length of Session(Required)1 hour2 Hours (different experience levels in each time slot)2 Hours (same experience level throughout).Session 1: Type of session(Required)Lecture OnlyLecture with space for PRESENTER demonstrationLecture plus movement by participantsOnly Movement based sessionGroup Exercise ClassSession 1: Equipment Requirements for Attendees and Equipment for Presenter (PC: Control button and click Mac: Command and click to select more than one)(Required)I require a data projectorI require a whiteboard and markersI require some other equipmentSelect ALL that apply Please assume NOTHING List all equipment you need - note the number supplied with be determined by other choices made in the application (i.e. if lecture and presenter demonstration is selected only 1 of the item will be supplied) Equipment Requests(Required)Session 2 Title:(Required) Session 2: This session can be presentedLive onlyVirtually if requiredSession 2: Session Description(Required)Session 2: Learning Outcomes (200 words Max - please use bulletpoints)(Required)Session 2: Technical Level you are pitching the session at(Required)NoviceIntermediateAdvancedSession 2: What prior experience would the attendees require?(Required)NoviceIntermediateAdvancedSession 2: Have you presented this session (or something very similar) at a FitEX Conference before?(Required)YesNoWhat year(s) did you present this session? Session 2: Length of Session(Required)1 hour2 Hours (different experience levels in each time slot)2 Hours (same experience level throughout).Session 2: Type of session(Required)Lecture OnlyLecture with space for PRESENTER demonstrationLecture plus movement by all participantsOnly Movement Based SessionGroup Exercise SessionSession 2: Equipment Requirements for Attendees and Equipment for Presenter (PC: Control button and click Mac: Command and click to select more than one)(Required)I require a data projectorI require a whiteboard and markersOther requirementsSelect ALL that apply Please assume NOTHING List all equipment you need - note the number supplied with be determined by other choices made in the application (i.e. if lecture and presenter demonstration is selected only 1 of the item will be supplied) Requested Equipment(Required)Session 3: Title(Required) Session 3: This session can be presentedLive onlyVirtually if requiredSession 3: Session Description(Required)Session 3: Learning Outcomes (200 words Max - please use bulletpoints)(Required)Session 3: Technical Level you are pitching the session at(Required)NoviceIntermediateAdvancedSession 3: What prior experience would the attendees require?(Required)NoviceIntermediateAdvancedSession 3: Have you presented this session (or something very similar) at a FitEX Conference before?(Required)YesNoWhat year(s) did you present this session? Session 3: Length of Session(Required)1 hour2 Hours (different experience levels in each time slot)2 Hours (same experience level throughout).Session 3: Type of session(Required)Lecture OnlyLecture with space for PRESENTER demonstrationLecture plus movement by all participantsOnly movement based sessionGroup Exercise SessionSession 3: Equipment Requirements for Attendees and Equipment for Presenter (PC: Control button and click Mac: Command and click to select more than one)(Required)I require a data projectorI require a whiteboard and markersOther EquipmentSelect ALL that apply Please assume NOTHING - we will list what equipment attendees should bring to participate based on your selection and we will ensure that the equipment you request is available (if we can't do this we will let you know before confirming your session) - Note you should self supply any props you need as a presenter of the sessionRequested EquipmentAre you presenting any of these sessions elsewhere 3 months either side of FitEX Conference? (You can do this we just like to know):(Required)YesNoPlease give details of the event (date, location etc).Your Location(Required) Auckland within 150Km of Auckland New Zealand non Auckland Overseas Name of City/Town you are based in(Required) Your Profile Photo -Head & Shoulders(Required)Accepted file types: anyphotoformat(jpeg, jpg, tiff, gif, png, pdf, Max. file size: 15 MB.Please supply a head holders shot for your profile - this should be a head and shoulders shot of you only. - Photos may be cropped to make them uniform. Your Profile: (Max 1500 characters)(Required)This profile will be used in the online Brochure - it can include links to other sites at the bottom of the profile. Max 1500 Characters (approx. 250 words) Have you been subject to any complaints or investigations (criminal or civil) that could be considered ' inappropriate conduct' by others, wether upheld or not?(Required)YesNoThis question related to any matter which includes, but is not limited to, complaints to any Organisation and/or employers, facilities or any criminal complaints. - If in doubt answer yes and give details below. Answering Yes does not disqualify you com speaking at our events, but full and honest disclosure is required. Full details should include: Information on the complaint, who it was made to, the outcome, the date, any other applicable information that will allow for full and honest disclosure.(Required)Terms and conditions - I Understand that: (tick to continue)(Required) This is an application only, none, some or all of my submitted sessions may be selected for presentation. Discussion on any travel allowance / subsidy will be entered into if sessions are selected before the speakers agreement is sent Payment is not made for speaking at the event Sessions should be educational - i.e. have take away info for attendees and should not be solely around the purchase of a product or service. Due to government regulation : Sessions will be selected using your declaration of vaccination status. I.e. if the government scraps the vaccination requirement we will consider all presenters who have applied. If the requirement is not removed by the time we select sessions we would be unable to offer a live speaking spot to unvaccinated presenters as there is a risk you may be not allowed entry to NZ. You may be required to apply for an NZeTA if you are not an NZ or Australian pass holder (we can not arrange this for you). If your sessions are selected you will be asked to also provide a short video outlining who you are and your sessions(s) - Info will be provided when speaker agreements are sent out. Select AllNote: to complete all of these T&C must be accepted. If you have concerns about any T&C please contact nathan@exercisenz.org.nz to discuss these. I have completed this application and would like to submit it now(Required)Yes