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2023 Arizona Health & Safety Summit: Call for Presenters
Proposals are due no later than April 30, 2023
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* Indicates required question
1. LAST Name
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Your answer
2. First Name
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Your answer
3. Middle Name Initial
Your answer
4. Are you a member of ASSP and/or AIHA?
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ASSP Member
AIHA Member
None of Either Organization
Required
5. Affiliations - Job Title, Organization
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Your answer
6. Mailing Address
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Your answer
7. City, State, Zip Code, Country
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Your answer
8. Email Address
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Your answer
9. Phone Number
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Your answer
10. Pertinent Biographical Information (150 words)
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Your answer
11. Title of Presentation
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Your answer
12. Brief Description / Abstract of the Topic (150 words)
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Your answer
13. List 3 Learning Objectives - Reference Bloom's Taxonomy and AVOID using "Know" "Learn" or "Understand".
13a. Learning Objective #1
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Your answer
13b. Learning Objective #2
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Your answer
13c. Learning Objective #3
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Your answer
14. How will attendees be able to demonstrate that the learning objectives were achieved?
*
Your answer
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