Workshop Submission Form
2017 Workshop

 

Contact Information
Your Name:
Your Title:
Hospital:
E-mail:
Daytime Phone:
Mobile Phone:
 

Workshop Information

Area: 2017 Workshop
 
Workshop Title:
Suggested Presenters:
Description:
Objectives:
Suggested Day(s)/Time(s):
Abstract Word Count: (500 words maximum)
Keywords: Please provide three keywords to describe your abstract:
 

Social Media Information
If selected for and presented at the conference, I give my permission for the Social Media Committee to post about my presentation on Twitter and other social media sites during the conference.
Twitter Handles:
Please provide your Twitter handle, and other handles, that should be tagged in social media posts about this presentation, should it be accepted and presented at the conference.
Draft Tweet:
Please provide a sample draft tweet that could be used to mention your presentation during the conference itself. There is no guarantee this text will be used, but it will help the Social Media Committee as they prepare content for the conference.

IMPORTANT NOTE: Please be sure to click the Submit button ONLY ONCE.