LSHA 2020 Convention Call for Papers
Thank you for your interest in presenting at our LSHA 2020 Convention in New Orleans, June 5-6, 2020. Please complete the following form in its entirety and our Convention Committee will contact you on or before April 1st should you be selected to present. Please be advised that our organization cannot supply funding for presenters, though we welcome you to join us at our Annual Business Meeting Luncheon on Saturday. Thank you!
Email address *
Primary Author's Name & Credentials *
Your answer
Mailing Address *
Your answer
Telephone number *
Your answer
Please select a format *
1 point
Required
Time Required *
1 point
Course Title for Disclosure *
Your answer
Content Area *
Please indicate which day(s) you are available to present *
If you have presented before, please indicate where and when.
Your answer
Please provide a brief biographical sketch of the Primary Author (50 words or less) *
Your answer
Do you have a Second Author? *
If you have a Second Author, please provide the following information: Name & Credentials, Email, Telephone Number, and brief biographical sketch.
Your answer
Please provide an Abstract of your Proposal *
Your answer
Objective 1: *
Your answer
Objective 2: *
Your answer
Objective 3:
Your answer
Please indicate the necessary requirements for your presentation (select all that apply) *
Required
Are you in compliance with HIPAA Requirements? *
Do you have a relevant financial relationship to disclose? If Yes, please describe the financial relationship. *
Your answer
Do you have a relevant non-financial relationship to disclose? If Yes, please describe the non-financial relationships. *
Your answer
Please provide your Electronic Signature for Disclosure
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy