MIRA 2019 Proposal Submission Form
Primary Presenter Name: (If there are multiple presenters, this is the presenter to whom all correspondence will be sent. *
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Primary Presenter Email: *
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Primary Presenter Job Title: *
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Primary Presenter Institution/Organization: *
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Additional Presenter Names
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Biographical information for presenter(s) *
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Proposal Information:
Format of Proposal: *
Proposal Title: *
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Proposal Description: *
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Session Learning Outcomes *
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Session Descriptors - Audience (check all that apply) *
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Session Descriptors - Topic (check all that apply) *
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Do you agree to your session being recorded and/or streamed? *
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