CAPMR Workshop Proposal Submission Form

Workshop Proposal Application - 2020 Annual Meeting, Charlottetown, PE

Deadline: MONDAY, February 3, 2020

A. Workshops may align with one of the following themes: general PMR, sub-specialty PMR or Canadian practice-related issues.

B. CAPMR does not provide any financial support or reimbursement, and there is no free registration of any kind, for workshop presenters.

C. At least one presenter in each workshop must be a member of CAPMR.

D. Standard A/V equipment will be provided (projector, laptop for presentation, clicker, microphones, etc.), excluding laptops for individual participants.

E. Workshops meeting criteria for Royal College Section 3 credits are also solicited.

Question Title

* 1. Title of Workshop

Question Title

* 2. Learning Track

General PMR

Sub-specialty PMR

Practice-related issues

Comments:

Question Title

* 3. Director

Name, Credentials and Professional Role *

Institution *

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address *

Phone Number *

Question Title

* 4. Co-Director 1

Name, Credentials, and Professional Role

Institution

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

Question Title

* 5. Co-Director 2

Name, Credentials, and Professional Role

Institution

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

Question Title

* 6. Co-Director 3

Name, Credentials, and Professional Role

Institution

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

Question Title

* 7. Co-Director 4

Name, Credentials, and Professional Role

Institution

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number