2008 PAEA Annual Education Forum Spotlight Presentation Proposal Submission Form
Please complete and submit this form by midnight, June 22, 2008.
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Title of Spotlight Presentation:
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Author(s)/Facilitator(s)
maximum of 2
(include academic and professional credentials and preferred e-mail address)
Primary contact (person to receive confirmation of material):
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Last Name
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First Name
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Credentials
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Institution
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Address
Address 2
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City
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State
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Zip Code
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Phone
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E-mail
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Educational goals and objectives (These should take the following format: "At the conclusion of this session, participants will be able to...")
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Description of session: This must follow format as outlined in the description and include a timeline of activities.
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References: (a maximum of the 5
major
references only) (for format information, click here)
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Target Audience
All
Program Directors
Medical Directors
Clinical Faculty
Academic Faculty
Clinical Preceptors
Other
Presentation rooms will be equipped with:
* IBM-compatible laptop computer with Microsoft XP including PowerPoint and software/hardware to accept presentation on USB drive or on a CD
* LCD data projector and screen
* Microphone(s)
Please indicate if other AV equipment or supplies are required (Additional equipment supplied pending approval by PAEA).
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Indicates Response Required
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