Presenter Information
 
First Name*
 
 
Last Name*
 
 
 
Credentials
 
 
 
Email*
 
 
 
Phone Number*
 
 
 
Job Title*
 
 
 
Company Name*
 
 
 
 
 
 
Professional Experience
 
 
 
 
 
Presenter's Previous Speaking Experience (include in-services, state, or national conferences, etc.)
 
 
 
 
 
Reference. If you are a first-time AAPACN presenter, please provide at least one reference who can attest to you experience as a presenter. List the name, email, phone number, and relationship to you.
 
 
 
 
 
Presenter Photo - Please upload a professional photo that may be used in conference promotional materials.
 
 
 
 
 
 
Presenter's Short Bio-Sketch (Limit to 175 words)
 
 
 
 
Co-presenter Information (Only for Sessions with Co-presenter)
 
Co-presenter Name
 
 
 
Co-presenter Phone
 
 
 
Co-presenter Email
 
 
 
Co-presenter Credentials
 
 
 
Co-presenter Job Title
 
 
 
Co-presenter Company Name
 
 
 
 
 
 
Co-presenter Professional Experience
 
 
 
 
 
Co-presenter's Previous Speaking Experience (include in-services, state, or national conferences, etc.)
 
 
 
 
 
Co-presenter Reference. If you are a first-time AAPACN presenter, please provide at least one reference who can attest to your experience as a presenter. List the name, email, phone number, and relationship to you.
 
 
 
 
 
Co-presenter Short Bio-Sketch (Limit to 175 words)
 
 
 
 
Session Information
 
Suggested Session Title (Limit to 10 words, be clear and concise)
 
 
 
 
 
Suggested Session Description (Begin with a one-sentence explanation as to why this topic is important and timely, followed by why it is relevant to the AAPACN audience. Limit to 80 words.)
 
 
 
 
 
Session Complexity
 
 
 
 
 
Session Format and Teaching Engagement Strategies (Check all that apply). 
Lecture
 
 
 
 
Case Study
 
 
 
 
Small Group Discussions
 
 
 
 
Panel
 
 
 
 
Q&A
 
 
 
 
Video
 
 
 
 
Demonstration
 
 
 
 
Role Play
 
 
 
 
Other
 
 
 
 
 
 
 
Suggested Target Audience (job titles and role in facility)
 
 
 
 
 
Learning Objective #1*
 
 
Learning Objective #2
 
 
Learning Objective #3
 
 
Learning Objective #4
 
 
 
 
Nursing CEs
 
Cite a Source (article, press release, piece of legislation, etc.) that demonstrates that this is a topic about which nurses need education.
 
 
 
 
 
Define the gap in knowledge, skills, or practice for the learner that your education session is designed to improve.
 
 
 
 
Wrap-up
 
Thank you for your submission! Please use this section to share with the content committee any additional information that would help them make their decisions.