DistanCE Webinar Submission

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* Presenter Name(s) & Affiliation(s)

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* Webinar Title

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* Webinar Topic

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* Course Description (150 words or less)

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* 3-4 Learning Objectives

Learning Objective 1

Learning Objective 2

Learning Objective 3

Learning Objective 4

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* Description of Target Audience

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* Instructional Level of Presentation

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* Please select desired webinar length

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* Please select webinar format

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* Please submit a short speaker bio for promotional use

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* Please upload speaker CV

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* Please upload speaker CV

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* Please upload speaker CV

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* Please upload a speaker photo for promotional use

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* Please upload a speaker photo for promotional use

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* Please upload a speaker photo for promotional use

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* Please upload a document with 8-10 multiple choice questions/answers for use with the recorded version of the webinar for homestudy CE credits