Call for 2020 Annual Conference Speakers
RequiredRequired Question(s)
Required 1.

Session Title

 

50 characters left.
Required 2.

Session Description

 

350 characters left.
Required 3.

Learning Objective 1

 

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Required 4.

Learning Objective 2

 

50 characters left.
Required 5.

Learning Objective 3

 

50 characters left.
Required 6.

Session Type

Concurrent
Keynote
Required 7.

Session Length

60 minutes
90 minutes
Required 8.

Presentation Format

Case Study
Lecture
Panel
Other  
Required 9.

Level of Difficulty

Basic
Intermediate
Advanced
Required 10.

Target Audience

General Interest
Hospice / End of Life
Keynote
Leadership
Med-Certified
Palliative Care
Private Duty
Required 11.
Please enter the information requested below - Please include professional designations after your name (ex: M.D., COS-C, etc.).

First Name:
Last Name:
Job Title:
Company Name:
Work Phone:
Email Address:
emailaddress@xyz.com
Address 1:
Address 2:
City:
State/Province
(US/Canada):
Postal Code:

Required 12.

Speaker Bio

 

350 characters left.
Required 13.

Do you have a co-presenter?

Yes
No
14.

Co-Presenter Name

 

50 characters left.
15.

Co-Presenter Company Name

 

50 characters left.
16.

Co-Presenter Title

 

50 characters left.
17.

Co-Presenter Email

 

50 characters left.
18.

Co-Presenter Bio

 

350 characters left.