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Call for Presentations - Breakout Session Speakers Only

AANAC 2012 Spring Conference & Exhibition - Jacksonville - Florida

Thursday, April 19, 2012 to Friday, April 20, 2012

Deadline for entries is October 3rd, 2011

Please fill out the form below, or copy and paste from your own document.
* denotes a required field

Presenter #1 Biographical Data

Membership Status

Member Non-Member

First Name *

Last Name *

Title *

Job Function * (include key daily tasks)

Credentials *

Home Address

Street
City	State	Zip

Business Address *

Street
City	State	Zip

Telephone *

Fax

Email *

Education *

(Include the basic preparation
through highest degree held)
Please include every degree you hold, your major, what year it was obtained and from what school. These items are needed for CE accreditation.

Year most recent degree completed *

Professional Experience *

Please describe briefly your professional experience or areas of expertise (including publications and other presentations).
500 character limit. This will be used in conference brochure and other materials.

Character Count:

If this will be your first AANAC presentation, please provide 2 speaking references

Presenter #2 Biographical Data

show

Membership Status

Member Non-Member

First Name *

Last Name *

Title *

Job Function * (include key daily tasks)

Credentials *

Home Address

Street
City	State	Zip

Business Address *

Street
City	State	Zip

Telephone *

Fax

Email *

Education *

Year most recent degree completed *

Professional Experience *

Character Count:

If this will be your first AANAC presentation, please provide 2 speaking references

Presenter #3 Biographical Data

show

Membership Status

Member Non-Member

First Name *

Last Name *

Title *

Job Function * (include key daily tasks)

Credentials *

Home Address

Street
City	State	Zip

Business Address *

Street
City	State	Zip

Telephone *

Fax

Email *

Education *

Year most recent degree completed *

Professional Experience *

Character Count:

If this will be your first AANAC presentation, please provide 2 speaking references

Presentation Information

Presentation Title *
Target Audience *
Program Topic * Select one category below which best represents your topic	Other:
Experience Level * Number of years in job that best describes your target audience.
Session Description * Please submit a one paragraph, executive summary to describe your sessions' overall purpose and content. This will be used in conference materials. 500 character limit.	Character Count:
Teaching/Learning Strategies used (e.g. delivery methods and resources)
Format:

Learning Objectives

Submit information related to these criteria for the entire activity. You must submit at least three objectives.
Objective #1 * List objectives in measurable operational/behavioral terms. Do not use the word "understand" as an objective
Content Please list topic area to be covered and provide a brief outline of content to be presented. 500 character limit.	Character Count:
Presenter

Objective #2 * List objectives in measurable operational/behavioral terms. Do not use the word "understand" as an objective
Content Please list topic area to be covered and provide a brief outline of content to be presented. 500 character limit.	Character Count:
Presenter

Objective #3 * List objectives in measurable operational/behavioral terms. Do not use the word "understand" as an objective
Content Please list topic area to be covered and provide a brief outline of content to be presented. 500 character limit.	Character Count:
Presenter

Objective #4 List objectives in measurable operational/behavioral terms. Do not use the word "understand" as an objective
Content Please list topic area to be covered and provide a brief outline of content to be presented. 500 characters limit.	Character Count:
Presenter