SDPA Dermatology Conference - Call for Speakers

SDPA is excited that you are submitting a proposal for an education session at the SDPA Dermatology Conferences! Please fill out this form entirely to have your session considered.

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* 1. Session Title (15-word max)

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* 2. Please provide a brief description of the session you are proposing.

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* 3. What kind of session would you like to submit?

An hour education session with multiple actionable insights for Dermatology Physician Assistants.

An hour Deeper Dialogue session that dives deeper into a specific topic.

A two-hour workshop that provides hands-on instruction to improve attendees’ understanding or performance in a specified area.

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* 4. Session Abstract (500 characters or less)

If selected to present, this description will be used in the conference program and website to market your program to attendees.

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* 5. Why should this session be selected for the SDPA Dermatology Conference?

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* 6. Actionable Takeaway #1

Please complete this sentence with three key takeaways: “Following my presentation, audience members will be able to…”

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* 7. Actionable Takeaway #2

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* 8. Actionable Takeaway #3

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* 9. Speaker's Full Name:

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* 10. Speaker's Title:

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* 11. Speaker's Organization:

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* 12. Speaker's Email:

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* 13. Speaker's preferred phone number

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* 14. Speaker's Social Media -Twitter, LinkedIn (if applicable)

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* 15. Other Speakers Names, Titles, Emails & Social Media (if Multiple Speakers)

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* 16. Do you have any conflicts of interest SDPA should be aware of?

Yes

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* 17. If you answered yes to Question 16, please list your conflicts of interest.

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* 18. Please list any speaking engagements within the past 18 months.

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* 19. Please upload your Speaker bio (as you would like it to appear on the conference website)

Allowable file types include PDF, DOC and DOCX

PDF, DOC, DOCX file types only.

Choose File

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* 20. Please upload a copy of your current CV.

Allowable file types include PDF, DOC and DOCX

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

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* 21. Please upload a high resolution lead Speaker Headshot (as you would like it to appear on the conference website)

Allowable file types include PDF, PNG, JPG, JPEG, GIF

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

SDPA Dermatology Conference - Call for Speakers

Question Title

* 1. Session Title (15-word max)

Question Title

* 2. Please provide a brief description of the session you are proposing.

Question Title

* 3. What kind of session would you like to submit?

Question Title

* 4. Session Abstract (500 characters or less)If selected to present, this description will be used in the conference program and website to market your program to attendees.

Question Title

* 5. Why should this session be selected for the SDPA Dermatology Conference?

Question Title

* 6. Actionable Takeaway #1Please complete this sentence with three key takeaways: “Following my presentation, audience members will be able to…”

Question Title

* 7. Actionable Takeaway #2

Question Title

* 8. Actionable Takeaway #3

Question Title

* 9. Speaker's Full Name:

Question Title

* 10. Speaker's Title:

Question Title

* 11. Speaker's Organization:

Question Title

* 12. Speaker's Email:

Question Title

* 13. Speaker's preferred phone number

Question Title

* 14. Speaker's Social Media -Twitter, LinkedIn (if applicable)

Question Title

* 15. Other Speakers Names, Titles, Emails & Social Media (if Multiple Speakers)

Question Title

* 16. Do you have any conflicts of interest SDPA should be aware of?

Question Title

* 17. If you answered yes to Question 16, please list your conflicts of interest.

Question Title

* 18. Please list any speaking engagements within the past 18 months.

Question Title

* 19. Please upload your Speaker bio (as you would like it to appear on the conference website)

Question Title

* 20. Please upload a copy of your current CV.

Question Title

* 21. Please upload a high resolution lead Speaker Headshot (as you would like it to appear on the conference website)

* 4. Session Abstract (500 characters or less)

If selected to present, this description will be used in the conference program and website to market your program to attendees.

* 6. Actionable Takeaway #1

Please complete this sentence with three key takeaways: “Following my presentation, audience members will be able to…”