Demonstration
Roundtable
discussion
Poster Session
Other _______________
Would you
be willing to become part of a panel?
Yes No
II. Title: (should accurately reflect content)
III. Program Description:
(50 words maximum
– This may be edited for inclusion in the program.)
IV. Summary: (300 words maximum)
V. Equipment Needed:
Please
bring your own laptop computer and LCD projector, if needed.
overhead projector easel / flipchart
other______________
VI. Presenter(s):
Name: Name:
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Title: Title:
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Institution: Institution:
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Address: Address:
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Office
phone: Office
phone:
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E-mail: E-mail
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