Southern Alberta Preceptor Summit 2020 - Speaker Forms

 

Thank you for agreeing to speak at the Southern Alberta Preceptor Summit. This year’s event will be delivered virtually, throughout the morning on Saturday, September 19, 2020. Unless otherwise specified, each session will be approximately 40 minutes in length (this must include activities, group discussions and question periods that you have planned). Speakers will present their session one time over the course of the conference.

 

We kindly ask that you review the Presentation Standards document and, if you will be incorporating a PowerPoint, please use the template provided here and include the mandatory slides. A copy of your final presentation will be requested at a later date and may be adjusted to fit the master slide-deck.

 

Please complete the following speaker form, download, fill and sign both COI documents (which can be found at the bottom of the page) and attach the signed copies to complete your submission.

 

We will contact you with Zoom details closer to the date. If you have any questions regarding your submission, please contact our Events Coordinator, Jessica Vause at jessica.vause@ucalgary.ca. 

 

 

Are you available to present on Saturday, September 19, 2020?
Please check all that apply:
Title & Institution
Title & Location
Max 150 words
Please upload a high resolution photo to be used in our program.
One file only.
100 MB limit.
Allowed types: gif, jpg, png.
Please select all that apply:

If you are a panelist, there is no need to supply a session title or objectives. Simply enter “N/A” into the fields below to continue with your submission.
Please list 3 session objectives for your presentation
Will your session require breakout rooms/small group activities?
Waiver
I consent to participate in the program or project identified above and agree that the handout materials that I provide for the program: (1) may be printed to be distributed to course registrants, (2) that my presentation and my person may be recorded in audio, video or still image format, and (3) that both 1 and 2 may be posted on a page of the DLRI office website (cumming.ucalgary.ca/ruralmedicine) following the date of the program. I will ensure that I am compliant with, and will use copyright-protected materials in accordance with, the University of Calgary copyright policy, Acceptable Use of Material Protected by Copyright. Furthermore, I understand that the Copyright Office (copyright@ucalgary.ca) is available to offer guidance, should I need assistance with this. I understand that the information collected will be used only for the purposes listed above. If I have any questions about the collection or use of this information, I will contact the DLRI office. I certify that I have read and fully understand this Waiver and that all questions pertaining to this Agreement have been answered to my satisfaction.
You may download a copy of the National Standard COI form here
One file only.
100 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.
You can download a copy of the CFPC COI form here
One file only.
100 MB limit.
Allowed types: gif, jpg, jpeg, png, bmp, eps, tif, pict, psd, txt, rtf, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, mp3.

Collection of personal information
Your personal information is collected under the authority of section 33(c) of the Freedom of Information and Protection of Privacy Act. If you have any questions about the collection or use of this information, please visit our Access to Information page.