Skip to content
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.
OK
*
1.
Session Title (15-word max)
(Required.)
*
2.
Please provide a brief description of the session you are proposing.
(Required.)
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.
*
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.
(Required.)
*
5.
Why should this session be selected for the SDPA Dermatology Conference?
(Required.)
*
6.
Actionable Takeaway #1
Please complete this sentence with three key takeaways: “Following my presentation, audience members will be able to…”
(Required.)
*
7.
Actionable Takeaway #2
(Required.)
*
8.
Actionable Takeaway #3
(Required.)
*
9.
Speaker's Full Name:
(Required.)
*
10.
Speaker's Title:
(Required.)
*
11.
Speaker's Organization:
(Required.)
*
12.
Speaker's Email:
(Required.)
*
13.
Speaker's preferred phone number
(Required.)
14.
Speaker's Social Media -Twitter, LinkedIn (if applicable)
15.
Other Speakers Names, Titles, Emails & Social Media (if Multiple Speakers)
*
16.
Do you have any conflicts of interest SDPA should be aware of?
(Required.)
Yes
No
17.
If you answered yes to Question 16, please list your conflicts of interest.
18.
Please list any speaking engagements within the past 18 months.
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
Choose File
No file chosen
*
20.
Please upload a copy of your current CV.
(Required.)
Allowable file types include PDF, DOC and DOCX
Choose File
No file chosen
*
21.
Please upload a high resolution lead Speaker Headshot (a
s you would like it to appear on the conference website)
(Required.)
Allowable file types include PDF, PNG, JPG, JPEG, GIF
Choose File
No file chosen
