Faculty Confirmation and Information Form


Please complete the information below as you would like it printed in our promotional materials.
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Contact Information

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Presentation Learning Objective Statements

Session #1: At the conclusion of this presentation attendees will be able to

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Compensation

The WA-ACEP agrees to provide faculty with complimentary meeting registration and parking.

Audio/Visual

We ask that you bring your presentation on a flash drive. For your presentation, WA-ACEP will provide a podium, microphone, screen, LCD Projector, and laptop computer.

Syllabus Materials

All speakers are required to provide contributions for the CME E-Syllabus. Please submit your contributions no later than March 31, 2016. Email to plp@wsma.org or send large files to Dropbox.

QuestionsContact Pauline Proulx at 206-956-3648 or send an email to plp@wsma.org

Please complete this form by Feb. 1, 2016

Email: plp@wsma.org