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* 1. Tell us about yourself.

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* 2. Secondary Presenter

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* 3. Are you a current member of the Home Care Association of New York State?

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* 4. If you are not a member would you like information on becoming a member?

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* 5. Presentation Topic:

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* 6. Presentation Title:

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* 7. Presentation description (abstract)

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* 8. Presentation Learning Objectives

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* 9. Upload biographical sketch for primary presenter.

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* 10. Upload biographical sketch of secondary presenter (if applicable).

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* 11. Has this program been presented previously?

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* 12. Will your presentation include handout materials?

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* 13. Who is your target audience? 

Select all that apply

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* 14. For which of the following do you wish this proposed presentation to be considered? Check all that apply

Note: Proposals for a signature event must be received at least 8 weeks prior to the date of the targeted event.

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* 15. What is the ideal length of time required for presentation (including Q&A)

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* 16. Have additional supporting documents or multiple presentation proposals? Please upload your supplemental document here.

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* 17. Do you require a speaker's fee?

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* 18. Please provide us with your speaker's fee.

0 of 18 answered
 

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