2016 Nursing Summit Breakout Proposal Form
Be part of the 2016 Nursing Summit by leading a discussion, presenting your ideas, sharing your skills! We welcome your conribution! You can submit more than one proposal! Due date for proposals is March 20, and we will notify you of your proposal outcome by April 15!
First Name *
Your answer
Last Name *
Your answer
Email address *
Your answer
Confirm email address *
Your answer
Provide a brief biosketch, including your earned degrees, title, current affiliation, and description of your background related to this session *
Your answer
Title of proposed session *
Your answer
Will other people co-lead this session with you? If so, provide their names, titles and qualifications *
Your answer
Brief description of the session *
Your answer
Describe how your session addresses LGBTQ health and/or healthcare *
Your answer
List 2 to 3 learning goals for your session *
Your answer
Indicate what media resources you need for this session *
Your answer
Indicate which of the following categories your session addresses (select all that apply) *
Required
Is there anything else we need to know?
Your answer
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