Presenter Information Form
National Conference on Worker Health and Safety: #COSHCON17

Form due no later than FRIDAY, NOVEMBER 3, 2017. If you have any questions, please email Susi Nord at: Susi@nationalcosh.org

Presenter Information: (List all presenters in your workshop session. Please include NAME, ORGANIZATION/AFFILIATION and EMAIL) *
Your answer
Workshop Title *
Your answer
Short Workshop Description (150 words max):
Your answer
Please indicate any technical assistance you will need for your session:
If you selected "other" for technical assistance, please detail here: (NOTE: All session rooms will be equipped with an LCD projector and screen, and a VGA connector. We are unable to provide a laptop, so if you plan to give a digital presentation please bring your own device.)
Your answer
Workshop Handouts: (If available please list all workshop handouts that will distributed during your session and specify if they will be available in English only, Spanish only, or Bilingual (English/Spanish). Please note that all presenters are responsible for bringing their own copies of handouts. We recommend bringing at least 25 copies of each handout.The conference coordinators will send you separate instructions on how to upload your workshop handouts to a Google Drive folder. )
Your answer
Presenter Bios: Please provide a brief bio for each presenter (150 words max for each)
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Are there any other needs/accommodations/things we should know about your presentation?
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