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Prefix
First Name  
Middle Name
Last Name  
Organization/Department
Home Phone  
Work Phone
Cell Phone
Email
AddressLine1
AddressLine2
City
State
Postal Code
Country

Concurrent Session Title (Title of your proposed concurrent session (the title will be used in the printed program):
Concurrent Session Topic Track (Topic track of your proposed concurrent session:
Concurrent Session Presentation Style (Presentation style of your proposed concurrent session:

Please use the 'Browse' buttons below to locate the appropriate files for upload. DO NOT type into these fields and attempt to Submit the Application as this behavior is not supported and the 'Submit' button will become inoperable
Concurrent Session Biography (Name and brief biographical sketch for each presenter (one paragraph each):
Concurrent Session Upload (Complete description of the proposed session (1 - 4 pages):
Concurrent Session Abstract (Abstract for the printed conference program (75 words maximum)) :

Please either enter abstract in the provided box or upload a file using the browse button. An uploaded file will take precedence over entered text.
Abstract Name
Abstract Content (maximum of 75 words)
OR

Select one of the following categories that best fits your proposed session regarding voluntary education:  








 

Experience level of intended audience:


 


Concurrent Session Additional Information:

The hotel will supply a 7'-8' tripod screen, a small draped table and electrical outlets in the breakout rooms. You must bring your own laptop and we strongly recommend that you bring your own projector equipment if they are necessary to your breakout. Will you need CCME to supply any hardware? Please list in the box below: