2025 MAPA Speaker Confirmation

2025 MAPA Speaker Confirmation

This submission will serve as confirmation and agreement that this respondent will speak at the 2025 Michigan Academy of Physician Associates (MAPA) Fall Conference, October 9-12, 2025, at the Grand Traverse Resort and Spa in Acme, MI.

At this time, MAPA is requesting your bio and headshot to help promote your presentation and the conference overall.

Speaker Information

First Name*

Last Name*

Email Address*

Bio*

Please provide a short bio for your introduction and promotion.

Headshot Photo*

Please provide a headshot photo for promotional use.

Drag and drop files here or

Honorarium Choice*

MAPA will offer a $250 honorarium per presentation, not per speaker.

Select

Address for Honorarium*

Street, City, State & Zip Code

Presentation Details

Copresenters*

Please indicate if you will have additional presenters in your session. If yes, we will contact you to collect their information.

Select

Acknowledgement of AV Equipment*

Yes, I acknowledge the following audio-visual equipment will be provided: WiFi, podium, LCD projector, and slide advancer with laser pointer. A PC laptop will be provided only if requested 30 days prior to the start of the conference.

Conference Attendance*

I plan to attend the full conference. (You must register)

I plan to just attend the day I speak. (You must register for full conference.)

I plan to just attend the session I am presenting.

I am unsure what my plans will be at this time.

Send me a copy of my responses

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