2025 Call For Presentation

2025 Call For Presentation

Primary Speaker Information

First Name*

Last Name*

Credentials

Company Name*

Company Position/Title*

Company Address*

City*

State*

Zip Code*

Phone*

Email*

Indicate the associations, if any, of which you are a current member (mark all that apply)

Select or enter value

All speaker fee and reimbursement requests must be indicated here.*

Or, indicate N/A to waive speaker fee and reimbursement requests.

Travel expenses includes all of the following and cannot exceed:

Roundtrip airfare (coach class) $1000
Rental care (compact or midsize) $70 per day
Mileage $0.655 per mile
One overnight hotel room per speaking day $150
Meals per speaking day $50

I understand that reimbursement requests and invoices must be received by NHCA within 30 days of the event.*

Reimbursement requests or invoices received after 30 days are forfeited.

Co-presenters

Will you have co-presenters?*

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Co-presenter 1 (Name, Phone, and Email)

Co-presenter 2 (Name, Phone, and Email)

Co-presenter 3 (Name, Phone, and Email)

References

If first time presenting for Nebraska Health Care Association.

Reference 1 (Name, Company and Email)

Reference 2 (Name, Company and Email)

Reference 3 (Name, Company and Email)

Presentation Information

Title of Presentation*

Session Description (100 words or less. Must be 4-5 sentences.)*

Learning Objectives*

Please list at least 3 Please click here for a list of recommended verbs - https://www.nehca.org/wp-content/uploads/Verbs-for-Objectives.pdf At the end of this session, attendees will be able to:

Topical Outline*

Please provide a topical outline of presentation.

Teaching-Learning Methodologies*

Describe the teaching-learning methods the speaker will use to:

Engage learners
Achieve learning outcomes
Provide take-home resources to attendees.

Examples: Case studies, lecture, panel, Q & A, PowerPoint, handouts, discussion, educational games, hands-on activities, demonstration, and/or role-playing.

Bibliography*

Provide a list of resources utilized in the presentation that are less than five years old.

Presentation Length*

Ex. 30 minutes, 60 minutes, 2 hours Note: Average length of session is 60-75 minutes

Audience*

Please select from the dropdown options below. If not listed, please type your audience and enter in the box below

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Speaker Disclosure Statement

It is the policy of the Nebraska Health Care Association to make best efforts to insure balance, independence, and objectivity in educational activities. All presenters are expected to disclose any affiliations that may have a bearing on the subject matter of their presentation.

Please check the box below if you have no actual or potential declarations to make in relation to this program.

Speaker Declarations

If you do have a competing interest or affiliation that could be perceived as having a bearing on the presentation, please list the current competing interests or affiliations below. By completing this form, you agree to provide an unbiased presentation.

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