North Central College Health Association
Annual Conference
October 15-17, 2008
Radisson Hotel
La Crosse, WI


Note: All fields are required (except for Co-Presenters)

 

 
Speaker Information
Name:
Degree(s):
Title/Position:
Institution:
Address:
City/State/Zip:
Phone (Work):
Phone (Fax):
Email:
 
Will you have co-presenters?  Yes      No
If yes, please list:
Name:
Phone (Work):
Email:
Name:
Phone (Work):
Email:
Name:
Phone (Work):
Email:
 
Please provide a ready-to-read introduction that describes each presenter's qualifications and experience. Limit to 250 words.
 
Please email a resume for each presenter in Microsoft Word format.

Proposal Information
Conference Theme:Best Practices in College Health Evidence Based Medicine
Title of Presentation:

Please be as creative as possible. This is how it will appear in all printed materials.
Main Objectives:
List 3-5 behavioral objectives (learning outcomes). We suggest you use action words like the following:
explain, identify, compare, contract, recite, define, differentiate, list, discuss.
Content Summary (similar to an abstract):
Summarize the main content of your session. Limit to 500-700 words.
Session Description:
Provide a description to be printed in publicity materials. Tell participants why they should come to your session and what they will learn. Use this opportunity to "advertise" your session by getting participants excited to attend your session! Limit to 50-75 words.
Audience:
(Check all that apply)
Physicians
Nurses
Pharmacists
Health Educators
Counseling Staff (psychologists, psychiatrists, counselors, nurses, social workers)
Administrators
Medical Assistants
Students
Presentation Style:
(Check one)
Poster display w/ scheduled Q/A period
(please submit a digital photo of your poster display via email)
Are you willing to repeat your session?  Yes      No
 
   

 




 
FOR MORE INFORMATION CONTACT:
University of Wisconsin-La Crosse
Continuing Education/Extension
1725 State Street; 205 Morris Hall
La Crosse, WI 54601
608.785.6506; toll-free 866.895.9233
Fax 608.785-6547
continuinged@uwlax.edu		 Hosted by: University of Wisconsin-La Crosse, La Crosse, WI