CALL FOR PAPERS – SUBMISSION FORM
“The Art of Hearing Conservation”
Please complete the following information in order to be considered to present at the 2013 NHCA Conference. Submissions MUST be typed and preferably emailed as an attachment to by the deadline dates noted below. Please include the following in the email subject line “NHCA 2013 Conference Presentation Submission”. Once this has been received and processed by NHCA staff you will receive a confirmation email. The Program Task Force will review your submission and notify you of your acceptance by September 15th.
To submit this information electronically go to:
http://www.hearingconservation.org/displayemailforms.cfm?emailformnbr=177863
Call for Papers - Submission Deadline – Wednesday, August 15, 2012
Presentation Submission Information:
Presentation Type:
q Thursday Workshop
q Friday/Saturday Platform
q Poster Presentation
Primary Presenter Name: ______Credentials: ______
Company/University: ______Address: ______
City: ______State/Province: ______Zip/Postal: ______Country: ______
Phone: ______Email (REQUIRED): ______
Primary Presenter Biography:
Please email a current speaker photo to along with your presentation submission. (Photos should be Tiff or EPS files of 150 dpi or larger in color.) Please do not submit photos imbedded in Word documents.)
Presentation Title:
______
______
Presentation Description: (150 words for workshops and platforms, 75 words for posters)
*Please submit print-ready abstracts. The Conference Spectrum Supplement will include the information you provide below if your presentation is accepted.
Presentation Learning Objectives:
(Please list three objectives conference attendees should learn from your presentation.)
1.
2.
3.
Audio Visual Information:
Thursday Workshop Audio Visual Information:
If selected as aworkshop presenter,you will need to plan on bringingyour own laptop as well as LCD projector if possible. If you are not able to bring thesematerialswe will need to know as soon as possible so we can make arrangements for you.
FridayPlatform Presenter Audio Visual Information:
If selected as aplatform presenter, you will need to submit your PowerPoint presentation AS WELL AS a PDF version of the presentation no later than Friday, February 8, 2013 to . A laptop will already be available for your use at the conference. The Program Task Force will also have all PowerPoint presentationspre-loaded onto the general session laptop for your convenience. *NOTE: The use of personal laptops will NOT be permitted!
Poster Presenter Information:
Ifyourpresentation is accepted as a poster presentation, poster boards will be availablein the exhibithallfor your use along with materials to hang posters. The standard poster boarddimensions are 4 ft (height) X 8 ft (width). More detailswill be distributed withacceptance letters.
Would you be willing to allow other presenters to use your laptop or LCD projector during the conference?
Circle: Yes No
Co-Presenter Information:
NOTE: If this information is not submitted, co-presenters will NOT be published in the program! If you have more than five co-presenters please follow the format provided below and submit all co-presenters information as a separate document.
How many co-presenters do you have? ______
Pleaseinclude the following information for each co-presenter:
Co-Presenter Full Name #1: ______Credentials: ______
Company/University: ______Address: ______
City: ______State/Province: ______Zip/Postal: ______Country: ______
Phone: ______Email (REQUIRED): ______
q Co-presenter photo submitted? (Required for Workshop submissions ONLY)
q Co-presenter biography submitted? (Required for Workshop submissions ONLY; Platform and Poster co-presenter biographies will NOT be included in the Conference Spectrum Supplement.)
Co-Presenter Full Name #2: ______Credentials: ______
Company/University: ______Address: ______
City: ______State/Province: ______Zip/Postal: ______Country: ______
Phone: ______Email (REQUIRED): ______
q Co-presenter photo submitted? (Required for Workshop submissions ONLY)
q Co-presenter biography submitted? (Required for Workshop submissions ONLY; Platform and Poster co-presenter biographies will NOT be included in the Conference Spectrum Supplement.)
Co-Presenter Full Name #3: ______Credentials: ______
Company/University: ______Address: ______
City: ______State/Province: ______Zip/Postal: ______Country: ______
Phone: ______Email (REQUIRED): ______
q Co-presenter photo submitted? (Required for Workshop submissions ONLY)
q Co-presenter biography submitted? (Required for Workshop submissions ONLY; Platform and Poster co-presenter biographies will NOT be included in the Conference Spectrum Supplement.)
Co-Presenter Full Name #4: ______Credentials: ______
Company/University: ______Address: ______
City: ______State/Province: ______Zip/Postal: ______Country: ______
Phone: ______Email (REQUIRED): ______
q Co-presenter photo submitted? (Required for Workshop submissions ONLY)
q Co-presenter biography submitted? (Required for Workshop submissions ONLY; Platform and Poster co-presenter biographies will NOT be included in the Conference Spectrum Supplement.)
Co-Presenter Full Name #5: ______Credentials: ______
Company/University: ______Address: ______
City: ______State/Province: ______Zip/Postal: ______Country: ______
Phone: ______Email (REQUIRED): ______
q Co-presenter photo submitted? (Required for Workshop submissions ONLY)
q Co-presenter biography submitted? (Required for Workshop submissions ONLY; Platform and Poster co-presenter biographies will NOT be included in the Conference Spectrum Supplement.)
Please submit this form to:
National Hearing Conservation Association
3030 W. 81st Avenue, Westminster, CO 80031
Phone: 303-224-9022; Fax: 303-458-0002;
Website: www.hearingconservation.org; Email: