2021 North East Physical Therapy Conference
Originally known as Regional Virtual Annual Conference.  Speaker Agreement / Contact Information
Sign in to Google to save your progress. Learn more
Email *
Speaker Agreement:
1. Please use the provided powerpoint template for your presentation. Will be loaded onto the Presenter Landing page.
2. This session is a peer reviewed / approved lecture.  There will be no honorariums however all presenters will be able to attend any recorded / live synchronous for free.
3. Conflict of Interest: Presenters may not self promote a product, service or business that he/ she is employed by.  Your bio may include your participation however the presentation may not be include self promotion.  
4. All sessions will be reviewed (if recorded) or monitored (if live on Nov. 13).
5. Your presentation may be highlighted, marketed prior to the event.

I agree to the above: *
Due Dates:
Pre-recorded sessions: October 20, 2021
Live Sessions on Nov. 13 will be recorded at that time.
All handouts: October 27, 2021
(Handouts will be converted to PDF)

I agree to the above: *
Conference offering following November 13
Pre recorded session and recorded sessions on November 13 will be available to registered attendees for up to one year.
Please indicate your preference below.
One answer per presentation.  Lead presenter needs to answer this question after consulting with other presenters if applicable.
Following the "live" conference on November 13, this presentation can be available for:
Clear selection
Please complete the following contact information.  This will be used to add you to our Virtual  Event Platform.
First Name *
Last Name (include all credentials) *
Title of Presentation
Do you have any changes to your presentation?
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Liberty Square Group. Report Abuse
Google Forms