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* 1. Session Title

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* 2. Speaker (enter position and organization as you would like them listed in the program)

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* 3. Audio-Visual Equipment
A computer and data projector will be provided. Please specify any additional equipment required:

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* 4. Educational Objectives: Please list 3 or more. The objectives should be written from the perspective of the learner, descriptive of what the learner will gain in knowledge, skills and attitudes as a result of participating in the event; and written to enable evaluation of achievement by the planners and participants.

Please use verbs that denote an observable action, such as “list, explain, summarize, discuss, compare, etc.” NOTE: It is no longer permitted to use words that indicate emotions or feelings such as “know, learn, appreciate, understand, recognize, etc.”

At the end of the session, the participants will be able to:

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* 5. Please indicate which CanMEDS roles you will address in this educational activity?

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* 6. Description: Please provide a summary of your presentation. At the end of your summary please indicate your target audience, for example, “The session will be of value to: Physiatrists, Medical Students, Residents.”

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* 7. Biography: Please provide a short bio (1-2 paragraphs)

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* 8. Upload a Photo

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

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* 9. NEURAM 2020 can make my presentation available to individuals who may be interested in accessing it by posting it on their national association website.

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* 10. Speaker Signature and Date: I, the undersigned, the author of this presentation, certify that I have obtained all customary and necessary permission to use and print any copyright material that appears in my presentation.

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