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2027 ASPAN Call for Speaker Proposals
Please review Call for Proposals requirements and guidelines prior to completing the form. Thank you.
1.
Primary Presenter Name and Credentials:
2.
Primary Presenter email:
3.
Primary Presenter City/State:
4.
Title of Lecture (60 character limit):
5.
Please identify which topic category the session pertains to:
Clinical
Research/EBP/QI
Leadership Management
Legal/Ethical/Standards
Special Populations
Competency/Safety
Education/Technology
Other (please specify)
6.
Description of Lecture to be used for conference website (2-3 sentences; do not include specific names of organizations or facilities):
7.
Identified knowledge gap/professional practice gap (explain why this topic is important/needed):
8.
Evidence to validate the professional practice gap:
9.
Identify the established professional competency that aligns with the identified professional practice gap and underlying educational needs:
10.
Provide the professional source (citation/reference) for the competency (must be a reputable source such as ASPAN. ANA, NLN, etc.):
11.
What is the desired learning outcome for this session? "To enable the nurse to increase knowledge on…"
12.
Will your employer commit to hotel and travel expenses to attend the National Conference prior to being selected as a presenter?
Yes, full funding
No
Yes partial, please list estimated amount
13.
Please provide name/credentials, email address, and city/state for each additional presenter:
Presenter 2 Name/Credentials:
Presenter 2 Email:
Presenter 2 City/State:
Presenter 3 Name/Credentials:
Presenter 3 Email:
Presenter 3 City/State
14.
List of references that support evidence-based content for the content of the presentation (Must be dated in the last 5 years):
Reference 1:
Reference 2:
Reference 3:
Reference 4:
15.
Please upload a Relevant Financial Relationships Disclosure Form for each presenter: (combine into one pdf if multiple):
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16.
Please upload a CV for the primary presenter:
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