October 15, 2020

ISHN 2021 Call for Proposals

ISHN Proposal Application

2021 INDIANA SCHOOL HEALTH NETWORK
VIRTUAL CONFERENCE
CALL FOR PROPOSAL APPLICATION

SUBMISSION DEADLINE: JANUARY 31, 2021
Please complete application fully. All information is to be written as it should appear in the conference and marketing materials should your proposal be selected.

Primary Contact Information

To be completed by the individual submitting the application and coordinating with the presenter(s).

Primary Contact Name *

Organization *

Address *

Address

Address

Address

City
City

State/Province
State/Province

ZIP/Postal
ZIP/Postal

Email *

Phone *

Presentation Overview

Title (10 word maximum) *
10 word maximum

Abstract/Summary (150 word maximum) *
This should be written as an outcome statement, e.g., “The purpose of this session is to enable the learner to...”

Learning Objectives (20 word maximum per objective) *
Include 1-4 objectives of your session. Learning objectives must indicate a demonstrable skill or knowledge to be acquired

Presenter Information

Complete the following for all authors, presenters, panel participants, or facilitators who will be assisting with the presentation. Submit additional documents as needed.

Number of Presenters *

Presenter 1

Name *

Organization *

Credentials

Address

Address

Address

Address

City
City

State/Province
State/Province

Zip/Postal
Zip/Postal

Country
Country

Email *

Phone *

Biography (100 word maximum) *

Headshot

Maximum upload size: 52.43MB

Social Media

Website

Twitter

Facebook

LinkedIn

Presenter 2

Name *

Organization *

Credentials

Address

Address

Address

Address

City
City

State/Province
State/Province

Zip/Postal
Zip/Postal

Country
Country

Email *

Phone *

Biography (100 word maximum) *

Headshot

Maximum upload size: 52.43MB

Social Media

Website

Twitter

Facebook

LinkedIn

Presenter 3

Name *

Organization *

Credentials

Address

Address

Address

Address

City
City

State/Province
State/Province

Zip/Postal
Zip/Postal

Country
Country

Email *

Phone *

Biography (100 word maximum) *

Headshot

Maximum upload size: 52.43MB

Social Media

Website

Twitter

Facebook

LinkedIn

Presenter 4

Name *

Organization *

Credentials

Address

Address

Address

Address

City
City

State/Province
State/Province

Zip/Postal
Zip/Postal

Country
Country

Email *

Phone *

Biography (100 word maximum) *

Headshot

Maximum upload size: 52.43MB

Social Media

Website

Twitter

Facebook

LinkedIn

Presenter 5

Name *

Organization *

Credentials

Address

Address

Address

Address

City
City

State/Province
State/Province

Zip/Postal
Zip/Postal

Country
Country

Email *

Phone *

Biography (100 word maximum) *

Headshot

Maximum upload size: 52.43MB

Social Media

Website

Twitter

Facebook

LinkedIn

Presenter 6

Name *

Organization *

Credentials

Address

Address

Address

Address

City
City

State/Province
State/Province

Zip/Postal
Zip/Postal

Country
Country

Email *

Phone *

Biography (100 word maximum) *

Headshot

Maximum upload size: 52.43MB

Social Media

Website

Twitter

Facebook

LinkedIn

Technology Information

All PowerPoint presentations and handouts must be submitted to ISHN 48 hours before session recording. Recordings will be scheduled starting April 1, 2021.

Videos will need to be sent separately as .mp4 files to ensure they play properly on the platform. DO NOT embed videos in the presentation.

Continuing Education (CE) Documentation

If your proposal is selected, you will receive additional documentation which must be completed and returned in a timely manner for your session to be included in the CE application. Information typically included in the CE documentation includes:

Course agenda

Target audience

Teaching methods

Reference/Resource list

Post-test

Initial to acknowledge *

Additional Comments
Please use the space above for additional comments, questions or concerns not addressed in the application.

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