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HAPS2017 Poster Proposal Submission Form
Human Anatomy and Physiology Society 2017 Annual Conference: May 24-28, 2017 (Wednesday to Sunday).
Hosted by University of Utah

**PROPOSAL DEADLINE IS FRIDAY, 17 FEBRUARY 2017**

First Presenter
All presenters must be registered for the Update Speaker Sessions portion of the conference by April 21, 2017 to be included in the conference proceedings. Registration information and poster guidelines can be found at hapsweb.org. Note that guidelines have changed for 2017 and only professional quality, one-piece posters are allowed.
Are you currently a member of HAPS?
Presenter name
Your answer
College, university, or other affiliation
Your answer
Email address
Your email address will be published in the conference brochure and will be used to communicate with you regarding your submission
Your answer
Confirm email addresss
Your answer
Mailing address
Your answer
Telephone
Your answer
Co-Authors
If you have co-authors please complete this section. If you do not have any co-authors, please choose "no" in the next question and skip to the Poster Information section. Co-authors do not need to be registered for the conference. More information about author and presenter policies can be found at hapsweb.org
Do you have any co-authors?
If no, then skip to the next section
Is the co-author a member of HAPS?
Co-author name
Your answer
Co-author college, university, or other affilitation
Your answer
Co-author title or position
Your answer
Co-author Email
Your answer
Confirm co-author email
Your answer
If more than one co-author, how many co-authors total?
If just one co-author, you may skip to the next section
If more than one co-author, please add name, affiliation, position, and email for each additional presenter
Co-authors do not need to be registered for or attend the conference.
Your answer
Poster information
If you are planning to propose more than one poster, please submit each poster proposal using separate proposal forms.
Title of proposed poster
(255 character limit)
Your answer
Abstract of proposed poster
(100 word limit) This will be used in conference publications, including the Conference Edition of HAPS-Educator.
Your answer
Has this poster been presented at a previous HAPS meeting?
This includes both regional meetings and annual conferences - informational only.
All potential conflicts of interest must be disclosed at this time. If you or any of your co-authors have any conflict of interest, please detail it in the space below. If none exists, please state that fact.
COI might include being a consultant, developer, or author for a company that sells in the A&P market. Another example might be that you are working on developing a tool that you plan to sell at a later date. Please see hapsweb.org for further clarification.
Your answer
If you the presenter and/or any of your co-authors are affiliated in any capacity with an outside or for-profit entity and/or your presentation has a premise that either directly or indirectly promotes the interests of an outside or for-profit entity then your session is considered a sponsored session. All sponsored sessions require a $75 session sponsorship and such sessions are limited to HAPS Annual Conference exhibitors.
Please indicate if you are planning a sponsored session. If so please acknowledge that you understand that an additional $75 fee will be assessed for your session. See hapsweb.org for further clarification.
If you are presenting a sponsored poster, what is the outside entity, service, or product being presented?
Your answer
Do you have any additional needs that we should consider when we schedule your poster session?
We'll do our best to accommodate your requests.
Your answer
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