Panel Proposal

Title of Proposed Panel  
Name of Chair  
Primary affiliation  
   
Mailing address    
  Line 1  
  Line 2  
  Line 3  
City  
State/Province  
Zip/Postal Code  
Country  
Work phone  
Cell or Home phone  
E-mail address  
E-mail address confirmation  
Scheduling constraints (if any)  
Special needs (if any)  
Other comments (if any)  


Presentation 1

Title of Proposed Presentation    
Name(s)  
Primary affiliation(s)  
  
Mailing address    
  Line 1  
  Line 2  
  Line 3  
City  
State/Province  
Zip/Postal Code  
Country  
Work phone  
Cell or Home phone  
E-mail address  
E-mail address confirmation  
Abstract (150-250 words)  
Audiovisual needs (if any)   
  PowerPoint
  Audio for PowerPoint
  Microphone
  Overhead Projector
  Dry Erase Board
  Flip Chart with Markers
  Other  
Scheduling contraints (if any)  
Special needs (if any)  
Other comments (if any)  


Presentation 2

Title of Proposed Presentation    
Name(s)  
Primary affiliation(s)  
  
Mailing address    
  Line 1  
  Line 2  
  Line 3  
City  
State/Province  
Zip/Postal Code  
Country  
Work phone  
Cell or Home phone  
E-mail address  
E-mail address confirmation  
Abstract (150-250 words)  
Audiovisual needs (if any)   
  PowerPoint
  Audio for PowerPoint
  Microphone
  Overhead Projector
  Dry Erase Board
  Flip Chart with Markers
  Other  
Scheduling contraints (if any)  
Special needs (if any)  
Other comments (if any)  


Presentation 3

Title of Proposed Presentation    
Name(s)  
Primary affiliation(s)  
  
Mailing address    
  Line 1  
  Line 2  
  Line 3  
City  
State/Province  
Zip/Postal Code  
Country  
Work phone  
Cell or Home phone  
E-mail address  
E-mail address confirmation  
Abstract (150-250 words)  
Audiovisual needs (if any)   
  PowerPoint
  Audio for PowerPoint
  Microphone
  Overhead Projector
  Dry Erase Board
  Flip Chart with Markers
  Other  
Scheduling contraints (if any)  
Special needs (if any)  
Other comments (if any)  


Presentation 4

(With panel sessions of only an hour and a half, no more than three or four presentations should be scheduled in a panel in order to allow adequate time for discussion among panelists and between the panelists and the audience)
Title of Proposed Presentation    
Name(s)  
Primary affiliation(s)  
  
Mailing address    
  Line 1  
  Line 2  
  Line 3  
City  
State/Province  
Zip/Postal Code  
Country  
Work phone  
Cell or Home phone  
E-mail address  
E-mail address confirmation  
Abstract (150-250 words)  
Audiovisual needs (if any)   
  PowerPoint
  Audio for PowerPoint
  Microphone
  Overhead Projector
  Dry Erase Board
  Flip Chart with Markers
  Other  
Scheduling contraints (if any)  
Special needs (if any)  
Other comments (if any)