The information provided will be promoted in the mobile application and online scheduling tool.
*Fields marked with an asterisk will be printed in the conference guide.

* 1. Event Type *

* 2. If you will be hosting a CNE symposia, please list the number of CNE contact hours that an attendee will receive from attending your event.

**If you are hosting a CNE symposia and will be providing enduring activities post-Congress, please send enduring activity materials to be included in the Mobile App to jweber@smithbucklin.com by March 1, 2017.**

* 3. Event Date*

* 4. Event Time*

* 5. Event Location*

* 6. Education Company Name*

* 7. Grant statement/statement acknowledging company(s) supporting the program*

* 8. Event Title*

* 9. Event Description. Please limit description to 75 words.

* 10. If you will be utilizing a direct registration link to an education company’s registration site, please list the website here. Otherwise leave blank.

* 11. Contact Information

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