Professional Research and Practices Takeaway Session Proposal Form
This form is for the 10-minute Takeaway Sessions during the Professional Research International Conference in EU July 25 - 27, 2019. Regional Director contact - Ingibjӧrg Jónasdóttir; dkg.rd.europe@gmail.com ALL FORMS ARE DUE BY 11:59 PM CST ON JANUARY 15, 2019.
Email address *
Last name of presenter *
Your answer
First name of presenter *
Your answer
Do you represent an international committee? *
If you represent an international committee, please describe which one or write N/A. *
Your answer
Telephone (home)
Your answer
Telephone (cell) *
Your answer
Email address for contact purposes *
Your answer
State Organization (Geographic) *
Your answer
Additional Presenters' Names (If none, put N/A) *
Your answer
Title of Takeaway (please limit to 10 words) *
Your answer
Specific description of Takeaway (limit to 25 words). *
Your answer
Please mark the specific Takeaway date and time you prefer: (Please make sure you will be in attendance at the conference for the date and time you select) *
By submitting this form, you are agreeing to attend the conference should your proposal be accepted. You also understand that you are expected to pay the conference registration fee as well as travel expenses and lodging. Additionally, you understand that DKG cannot reimburse presenters or state organizations for any expenses incurred for this Takeaway session. *
Please note that you should slide the button on the bottom of the survey to receive a copy of your responses from this form. *
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