The purpose of this form is to gather presenter materials and additional information. Presenter images and bio sketches may be used for promotional purposes.Contact us at professional.development@nursing.wisc.edu with questions. Your Name: * Email address A copy of your submitted form will be sent to the below email address Activity Title: * Name of course, conference, workshop or summit. Your Presentation Title: Date: Date of presentation or anticipated launch date for enduring programs; refer to the letter you received. Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20232024202520262027 Please upload the following files: Presenter Image Files must be less than 2 MB.Allowed file types: gif jpg jpeg png pdf doc docx odt. Bio Sketch Files must be less than 2 MB.Allowed file types: pdf doc docx odt. Presentation slide set/Outline Slide sets are not required.Files must be less than 1 GB.Allowed file types: doc docx odt ppt pptx. Handout 1 Presenters are not required to have handouts.Files must be less than 1 GB.Allowed file types: pdf doc docx odt ppt pptx. Handout 2 Presenters are not required to have handouts.Files must be less than 1 GB.Allowed file types: pdf doc docx odt ppt pptx. Handout 3 Presenters are not required to have handouts.Files must be less than 1 GB.Allowed file types: pdf doc docx odt ppt pptx. I grant permission for organizers to share a pdf version of my slide set and handouts with participants. Yes No Leave this field blank