APTA Wisconsin Conference Session Submission

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* 1. Full Name and Credentials

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* 2. Email Address

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* 3. Phone Number

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* 4. Address

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* 5. Speaker Bio(s)

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* 6. Affiliated Institution or Practice

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* 7. Speaking Experience Level

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* 8. Teaching Method

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* 9. Session Title

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* 10. Session Objectives

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* 11. Session Description (120 words or less)

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* 12. Session Outline

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* 13. Three references to support your session content published within the last 7 years.

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* 14. Conference set up includes classroom style table arrangement with a screen, microphone, podium and projector provided by the Association. If your course requires additional resources or an alternate set up please list your requirements below.

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* 15. Clinical Practice Specialty

Sports

Ortho

Geriatrics

Pediatrics

Oncology

Neurology

Women's Health

Health and Wellness

Ethics

Radiology/Imaging

Acute Care

Spine

Aquatics

Wound Management

Other (please specify)

A $200 honorarium will be awarded to each selected session. In addition, one hotel night stay will be provided if the speaker lives more than one hour from the conference location.