AEIRS Webinar Speaker Application-WWW.AEIRS.ORG

AEIRS Webinar Speaker Application

Please complete this application to present at an upcoming AEIRS Webinar. Proposals should address contemporary or emerging issues related to education in imaging and radiologic sciences.

Primary Presenter

NOTE: Primary Presenter must be an active AEIRS member.

First Name

Last Name

Academic Degrees Earned

Professional Credentials

Position/Title

Institution/Organization

Address

Phone Number

Fax Number

Are you an AEIRS Member?

Yes

Co-Presenter

NOTE: The Primary Presenter must be an AEIRS member.

Name

Academic Degree/Credentials

Position

Institution/Organization

Address

Phone Number

Are you an AEIRS Member?

Yes

Title of Presentation

Session Description

Please supply a 5-6 sentence description of your topic. Please limit your session description to 100 words. Be as specific as possible about the material you will cover in the session. Your description will be used in writing the meeting brochure. Descriptions that are too short or vague will be returned.

Please enter your session description below

Outline

Please supply your research presentation outline.

Please enter your outline below.

Learning Objectives

List the three things that the participants will be able to do at the end of the session. These learning objectives should take the form of “You will learn to…” followed by at least 3 bulleted items that attendees will learn. Sessions submitted without learning objectives will not be considered. • Describe major elements of the study design • Discuss the authors’ conclusions • Identify possible implications for practice

Upon completion of the webinar, attendees will be able to:

Please include a short biography for each presenter (total length of one paragraph for all presenters):

Have you presented this topic at another conference?

Yes

If yes, please specify the date and association for which it was presented.

Applications must be submitted electronically to be considered.

A high resolution photo, preferably a headshot, will be requested at the time of acceptance for event promotional use.

Please direct any questions to events@aeirs.org.