2024 WSDA 90th Annual Meeting – Faculty Information Form


Thank you for accepting our invitation to participate on the faculty of the WSNS 20th Annual Meeting.

1Speaker Information
2Financial Disclosure

Speaker Information

Please complete the information below as you would like it printed in our promotional materials.
Name(Required)
Mailing Address
*Cell Phone Contact for an emergency only
To prevent important meeting information from going to your junk/spam folder or being blocked by your institution.
Drop files here or
Accepted file types: pdf, doc, docx, pages, Max. file size: 256 MB.
    Drop files here or
    Accepted file types: jpg, png, gif, Max. file size: 256 MB, Max. files: 1.

      Presentation Details

      Date
      Honorarium(Required)
      The WSDA honorarium is $250.00 per lecture hour. Please choose from the following options:
      Audio / Visual
      We ask that you bring your presentation on a UBS Flash Drive. For your presentation, WSNS will provide a podium, microphone, screen, LCD Projector, and laptop computer.

      Objectives

      The following section MUST be completed for CME documentation purposes. Should this section not be adequately addressed CME for this activity may not be awarded.
      Hidden
      Please describe the professional practice gap that underlies the need that your talk will address for the intended target audience. (The difference between current practice and best practice is the professional practice gap.) What do attendees need to learn?
      Hidden
      Objectives:(Required)
      Ideally, objectives should be stated in behavioral terms, not solely knowledge-based. They should describe what, at the end of this activity, do you want your learners to be able to do?

      Add more objectives by clicking the (+) button to the right.