Thank you for your interest in submitting a proposal for the Advancing a Healthier Wisconsin Endowment 10th Anniversary conference, entitled Looking Back, Moving Forward. We are looking forward to the opportunity to recognize the work our funded projects do to advance the fields of research, education, and public and community health.

The following survey does NOT allow you to save your work and complete your submission at a later time. Please have all materials ready for submission per the questions provided on the Call for Presenters/Posters. Questions marked with * are required fields to complete.

If you have any questions regarding the submission process, please contact Michelle Smith-Beckley by phone at 414.955.8410 or email at

* 1. Presentation/Poster Title:

* 2. Submitting Presenter's Name (main contact):

* 3. Submitting Presenter's Title:
(Examples: Executive Director, Professor, Program Manager, etc.)

* 4. Submitting Presenter's Organization Name:
(Example: Medical College of Wisconsin, Wisconsin Public Health Association, etc.)

* 5. Submitting Presenter's Mailing Address:

* 6. Submitting Presenter's Phone Number (including area code):

* 7. Submitting Presenter's Email Address:

* 8. Due to the presentation formats, only one additional presenter is allowed. Does this submission have a co-presenter?