Presenter Biographical Information

 

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* First Name

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* Last Name

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* Credentials (i.e. JD, BS, LNHA, RN)

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* Title

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* Company/Organization

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* Street Address

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* City

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* State

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* Zip

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* Business Phone

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* Cell Phone (in case of emergency)

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* Fax

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* Email

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* Secretary/Assistant/Other Email

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* How would you best describe your experience in teaching, presenting or developing educational programs/materials?

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* Have you ever presented at an HCAM &/or MCAL educational event?

Please list ALL post-secondary education and degrees completed. This information is REQUIRED for continuing education contact hours.

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* Degree (i.e. JD, MA, BA)

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* Major of Study

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* Academic Institution

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* Academic Institution Location (City & State)

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* Do you have other degrees?

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