Thank you for your interest in contributing to our symposium. Please complete the following questionnaire to submit your proposal for a breakout session. Please submit no later than Friday, October 4. If you have any questions, please contact our contract conference planner, Katrina Harris, at kharris@bridgeconsultingcorp.com or 610.494.8044.

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* 1. Breakout Session Point of Contact

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* 2. Presenter 1

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* 3. Presenter 2 (if applicable)

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* 4. Presenter 3 (if applicable)

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* 5. Proposed Session Title and Description (max 200 words)

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* 6. Learning Objectives (2-3 key takeaways or learning outcomes)

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* 7. Session Format (check one)

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* 8. If you selected Other as the Session Format, please explain here.

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* 9. Which topic(s) will this session address? (check all that apply)

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* 10. If you selected Other in Question 9, please explain here.

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* 11. Preferred Session Length (check one)

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* 12. Audio-Visual Equipment Requirements (check all that apply)

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* 13. Additional Comments or Requirements

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* 14. By submitting this proposal, I acknowledge that I am committed to presenting at DDAP's symposium on Tuesday, November 19, if selected.

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