2017 Student Wellness Retreat Call for Proposals

Notification of your submission status will be sent to you by early March

Name*

First Name

Last Name

Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Email*

Employer or Company name*

Job Title (please submit the job title you would like used in the conference program if your session is selected)*

Presentation Title*

Type of Presentation*

Lecture Demonstration Panel Discussion Interactive Physical Activity

Other:

Check all that apply

Brief Description*

Please include your expertise on this topic. This description will be used in the conference program. This description must be kept to one paragraph maximum. Please review carefully, as this description will be used in the conference program. Be sure to include your expertise/experience on this topic.

Maximum Number of Guests per Session*

Will you be giving anything away?*

Yes No

What will you be giving away?*

Which time slots do you prefer to present during the sessions on Friday, April 7*

8:30 - 9:30 am 9:45 - 10:45 am 11:00 am - 12:00 pm 2:30 - 3:30 pm 3:45 - 4:45 pm

Check all that apply

Would you consider presenting multiple times?*

Yes No

How many times would you consider presenting?*