Network Conference Participation Request Form Question Title * 1. Conference Information Association Name Conference Dates Expected No. of Attendees Conference Theme City and Venue Conference Organizer Conference Website Email Address Phone Number Question Title * 2. Will your association provide CNA with: Yes No a free booth space a free booth space Yes a free booth space No a free registration a free registration Yes a free registration No Question Title * 3. Deadline for CNA to confirm participation: Date / Time Date Question Title * 4. If you want CNA to have an exhibit space at your conference, please indicate the type of information that would be useful to your members. CNA General Certification Canadian Nurses Foundation Other (please specify); Question Title * 5. If CNA staff are unable able to attend your conference, do you want to receive promotional materials? Yes No Question Title * 6. Please indicate which activities you would like CNA to participate in: CNA President CNA President Elect CNA Chief Executive Officer Certification Staff CNA Staff Greetings at Opening Ceremony Greetings at Opening Ceremony CNA President Greetings at Opening Ceremony CNA President Elect Greetings at Opening Ceremony CNA Chief Executive Officer Greetings at Opening Ceremony Certification Staff Greetings at Opening Ceremony CNA Staff Plenary Plenary CNA President Plenary CNA President Elect Plenary CNA Chief Executive Officer Plenary Certification Staff Plenary CNA Staff Concurrent Session Concurrent Session CNA President Concurrent Session CNA President Elect Concurrent Session CNA Chief Executive Officer Concurrent Session Certification Staff Concurrent Session CNA Staff Pre-conference Workshop Pre-conference Workshop CNA President Pre-conference Workshop CNA President Elect Pre-conference Workshop CNA Chief Executive Officer Pre-conference Workshop Certification Staff Pre-conference Workshop CNA Staff Social Event Social Event CNA President Social Event CNA President Elect Social Event CNA Chief Executive Officer Social Event Certification Staff Social Event CNA Staff Certification Update Certification Update CNA President Certification Update CNA President Elect Certification Update CNA Chief Executive Officer Certification Update Certification Staff Certification Update CNA Staff Greetings at Board Meeting Greetings at Board Meeting CNA President Greetings at Board Meeting CNA President Elect Greetings at Board Meeting CNA Chief Executive Officer Greetings at Board Meeting Certification Staff Greetings at Board Meeting CNA Staff Presentation at Annual General Meeting Presentation at Annual General Meeting CNA President Presentation at Annual General Meeting CNA President Elect Presentation at Annual General Meeting CNA Chief Executive Officer Presentation at Annual General Meeting Certification Staff Presentation at Annual General Meeting CNA Staff Presentation at Board Meeting Presentation at Board Meeting CNA President Presentation at Board Meeting CNA President Elect Presentation at Board Meeting CNA Chief Executive Officer Presentation at Board Meeting Certification Staff Presentation at Board Meeting CNA Staff Written Greetings Written Greetings CNA President Written Greetings CNA President Elect Written Greetings CNA Chief Executive Officer Written Greetings Certification Staff Written Greetings CNA Staff Question Title * 7. Please confirm the date you want to receive written greetings Date / Time Date Question Title * 8. If a CNA executive is not available for the activity you have chosen above, do you want us to find another CNA staff to attend? Yes No Question Title * 9. If there are other activities you would like CNA to participate in, please provide specifics: Done
