KIM: Kids In Motion

KIM Conference: Abstract submission form

Complete this form to submit an abstract. All abstracts are due by Midnight, February 12, 2010. Please fill in the information below. Please self promote on this form. It is used to qualify for continuing education credits and all relevant factual information will assist in this process. You are submitting to speak because you have specialized information to share. This information is to support your expertise. Required fields are noted with an asterisk (*).

Please review the guidelines for presentations.

Contact Information

Name:	*
eMail:	*
Organization:	*
Degree(s):	*
Degree(s) are from:	*
Current employer:	*
Job position:	*
CPS activity & Tech or Inst:	*
Phone:	*
Cell:	*

Abstract information

Click here to read the disclosure.

I have read the disclosure?:
Do you or a family member receive gains from this presentation, Enter does or does not:	*
Complete the following:
Presentation Title:	*
Objectives:	*
Summary:	*

If you are selected to present we will request a CV or Resume in order to qualify the program for CEU accreditation.