BIANYS' Annual Conference will be held June 11-13, 2025, at the Holiday Inn in Saratoga Springs, NY.
For more information click on this link: https://link.bianys.org/2025ACCFP

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* 1. What is your first name? (if you have more than one presenter please list the main contact)

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* 2. What is your last name?

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* 3. List your Post-Nominal letters if applicable.

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* 4. What is your email address?

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* 5. What is your organization/workplace? (If applicable)

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* 6. What is your title? (If applicable)

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* 7. Please check all the audience(s) to which your presentation applies.

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* 8. Which audience do you feel your presentation is most applicable for?

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* 9. What is the title of your presentation? (maximum of 60 characters including spaces)

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* 10. Please provide a brief description of your session. (maximum of 1000 characters including spaces)

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* 11. Session Objectives: By completing the following sentence, provide three specific learning outcomes and/or knowledge/skills attendees will gain. 

At the conclusion of this session, the participant should be able to:

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* 12. Brief Biography of the presenter (maximum of 1200 characters including spaces)

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* 13. Please check ALL the dates and times you are available to present.

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* 14. Please attach a current CV or Resume. (This is required to give Continuing Education Credits to Attendees)

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
Choose File

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* 15. I acknowledge that if accepted to present I am responsible for travel and lodging costs. If I want to attend the entire Annual Conference I will pay the registration fee. (If you are just presenting at your session you will not need to pay)  If you are a brain injury survivor you may be eligible to apply for a scholarship.

Please initial.

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* 16. Will you have any co-presenters?

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