NHOTA SIS / COP Proposal Submission Form
Please use this form to officially submit a SIS presentation proposal.
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Submitted by *
Submitter's email *
Submitter's phone *
SIS Chair Coordinator 
Special Interest Section or Community of Practice *
Topic/ Title *
Day/date of SIS
Time of SIS/ COP
Number of CEUs
Venue Name and Address
Audio/ Visual Needs
Presenter's Name, Credentials and Title *
Presenter's Address
Presenter's Email *
Presenter's Phone Number *
Presenter's brief bio (will be used to introduce/ promote session) *
Does the presenter consent to share digital presentation with attendees after the SIS? *
List Goals/ Objectives of Session (3)
Are there any additional presenters? If yes, list their name and credentials here.
Contact information (email and phone) for additional presenters
Anything else we should know?
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