1.Presentation Title:

2.Learning Objectives 
At the end of the presentation participants will be able to:

1.

2.

3.

3.Topic areas to be addressed:

1.

2.

3.

4.Target Audience: (Check All the Apply) 

Public Health Professionals 

Educators 

Community Organization Specialists

Pharmacists 

Tobacco Specialists

Behavioral Health Providers 

Health Providers 

Organization Leaders

Others 

5.Level of Knowledge for Session

100 Level (Beginner)

200 Level (Advanced)

6.Presentation Description and Description of teaching method (s) to be used (400 word maximum):

Choose FileNo file chosen

7.Presenter 1:

First and Last name: 

Degree (s) Credentials:

Professional Title:

Name of Organization:

Organization Address:

Email Address:

Phone: 

Please provide a brief bio for Presenter 1 (150 word maximum):

8.Presenter 2 

First and Last name: 

Degree (s) Credentials:

Professional Title:

Name of Organization: 

Organization Address:

Email Address: 

Phone: 

Please provide a brief bio for Presenter 2 (150 word maximum):