Presentation Application - CAHSAH Annual Conference (Page 1)


Welcome to the CAHSAH online Conference Speaker Presentation Application. There are two pages to complete. All required fields must be filled in (indicated with a *) and completeness is encouraged. The first page will gather information about the presentation and the presenter(s). The second page page explains our compensation policies.
 
PRESENTATION INFORMATION
   
*Session Title: 
*Session Description:  Please limit to 50 words or less (if selected, this paragraph will be used in promotional brochure).
 
   
*Learning Objectives:  After successfully completing this session, participants will be able to:
  1. 
  2. 
  3. 
   
*Discussion Question:  Discussion question will be used to promote attendee engagement for your session.
   
   
*Session Type:    Keynote     Concurrent
*Session Length:    90 Minutes     180 Minutes
*Presentation Format:    Lecture     Panel     Case Study     Other
*Level Of Difficulty:    Basic (new staff)     Intermediate (3-5 yrs of experience)     Advanced (5+ yrs of experience)
   
*Target Audience:   Please check the target audience for your presentation
      Hospice/End of Life     Private Duty     Med-Certified     Leadership    
      General Interest     Keynote
   
PRESENTER INFORMATION
   
*Presenter: 
*Organization: 
Title:  Degree(s): 
*Address:  *City: 
*State:  *Zip Code: 
*Telephone:  *Mobile Phone: 
*E-Mail:  Fax Number: 
*Biography
(Curriculam Vitae): 
   
CO-PRESENTER INFORMATION (if applicable)
   
Co-Presenter: 
Organization: 
Title:  Degree(s): 
*Telephone:  *Mobile Phone: 
*E-Mail:  Fax Number: