2018 Convention Presentation Proposal

Welcome!

We invite you to provide a presentation proposal to be considered for the UHCA Annual Convention or Education Events. Please be sure provide all requested information. Thank you!

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* 1. Address

Name *

Company *

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Email Address *

Phone Number *

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* 2. Presentation Information

Presentation Title

Presenter Name

Presenter Company

Presenter Email

Presenter Cell Phone

Presentation Co-Presenter or Panelists (if applicable)

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* 3. Presentation Learning Objectives

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* 4. Please provide a 10-20 sentence overview of the presentation. Please note, this overview will be used in marketing and promotional materials. Please be sure it is complete, provides information on what the presentation will cover, what attendees will learn or take away, and sparks interest to motivate people to attend the session.

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* 5. Please provide a one or two paragraph bio that can be used in marketing materials. Please note, if you have more than one presenter, or a panel of presenters, please provide information for all.

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* 6. Please select all of the following that apply to your presentation

Assisted Living Focused

Skilled Nursing Focused

General Audience

60-minutes

90-minutes

120-minutes

Owner

Administrator/Executive Director

Nurse Manager

Building Engineers/Maintenance

Recreation

Social Work

Other (Please specify any other target audience or time necessary for this presentation)

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* 7. Presentation Budgetary Considerations (please select all that apply)

Honorarium Required

Travel Reimbursement Required

I am willing to provide this presentation at no cost to UHCA as a sponsorship for the Annual Convention or other education sessions. Please provide notes on the honorarium and/or travel reimbursement requirements if you are not providing this presentation as a sponsorship. specify)

Additional Comments