ICAA Conference

ICAA conference

Poster Presenter Application

I have read and understand all the information in the Call for Poster Presentations.

* Asterisk indicates required fields.

Primary presenter information

*Contact First Name:

*Contact Last Name:

*Title:

*Organization/Agency Name:

*Address:

*City:

*Country:

*State/Province:

If not applicable, please enter N/A.

*Zip/Postal Code:

If not applicable, please enter N/A.

*Phone Number:

Fax Number:

*E-mail Address:

Please check here for the secondary presenter information

Secondary presenter information

*Contact First Name:
*Contact Last Name:
*Title:
*Organization/Agency Name:
*Address:
*City:
*Country:
*State/Province:	If not applicable, please enter N/A.
*Zip/Postal Code:	If not applicable, please enter N/A.
*Phone Number:
Fax Number:
*E-mail Address:

Presentation title
Limit to 15 words

Poster category

New research will be presented in this poster?

	Yes
	No

Research in this poster has been presented at ICAA or other conferences?

	Yes
	No

If yes, where and when?

Abstract

Write a description. Limit to 350 words

Learning objectives

List three objectives

Primary presenter biography

Please provide a biography (50 words) that includes your academic credentials, title and experience.

Primary Presenter Acknowledgment

I understand that poster presenters at the ICAA 2012 conference receive the discounted registration of $309.00 to attend all other conference activities.
I am responsible for all expenses, including travel and accommodations.