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Call for Presentations - Breakout Session Speakers Only

Atlanta April 14-15, 2011
*Deadline for submissions is November 6th, 2010. No keynote speakers. AANAC may pay modest honorariums for breakout session speakers.

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, what year it was obtained and from what school.
Professional Experience * Please describe briefly your professional experience or areas of expertise (including publications and other presentations). 50 word limit. This will be used in conference brochure and other materials.	Word 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 * (Include the basic preparation through highest degree held)
Professional Experience * Please describe briefly your professional experience or areas of expertise (including publications and other presentations). 50 word limit. This will be used in conference brochure and other materials.	Word 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 * (Include the basic preparation through highest degree held)
Professional Experience * Please describe briefly your professional experience or areas of expertise (including publications and other presentations). 50 word limit. This will be used in conference brochure and other materials.	Word 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. 50 word limit.	Word Count:
Teaching/Learning Strategies used (e.g. delivery methods and resources)

Learning Objectives
Breakout sessions are limited to 1 hour and 15 minutes including time for questions and answers

Submit information related to these criteria for the entire activity. You must submit at least three objectives.
Objective #1 * List objectives in measurable operational/behaviorial 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. 50 word limit.	Word Count:
Presenter

Objective #2 * List objectives in measurable operational/behaviorial 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. 50 word limit.	Word Count:
Presenter

Objective #3 * List objectives in measurable operational/behaviorial 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. 50 word limit.	Word Count:
Presenter

Objective #4 List objectives in measurable operational/behaviorial 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. 50 word limit.	Word Count:
Presenter

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