2019 VA Catalyst/VNI Webinar series
You must be a VNI member to participate and have a Google account to submit this form. If you do not have a Google account or have questions, please email kbell@virginiacatalyst.org. Webinars will be posted on the VNI web site and should consist of slide presentations of 30 minutes duration. Media release forms will be emailed to you after submission of this form.
Email address *
Are you a VNI member? *
Presenters (First, Last, Degree): *
Presenters' Contact information (phone, email): *
University/Medical Center affiliation: *
What date are you available (1st choice)? *
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What other date are you available (2nd choice)? *
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What other date are you available (3rd choice)? *
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DD
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YYYY
Seminar title: *
Brief Description (4-5 sentences): *
Presenters' photo(s) (optional):
Presentation materials (can be uploaded later):
CV/Biosketch: *
Required
Any other comments and/or questions?
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