CALL FOR PRESENTATION PROPOSAL

Louisiana Organization for Associate Degree Nursing

2007 Annual Convention

Registered nurses are invited to submit presentation proposals on a variety of topics related to nursing practice, administration, research and education.

 Submission Format:

Session Presentation:  Submit an abstract of 250 words or less; complete the attached Education Design form and LSNA Biographical Data form.  The LSNA Biographical Data form must be completed for each presenter.

 Poster Presentation:  Submit an abstract of 250 words or less and the attached Data Form for Poster Presentations.

 Evaluation Criteria:

Abstracts will be reviewed by the Program Committee for clarity, relevance and implications for nursing.

 Convention Registration:   One free convention registration will be offered to each session selected for presentation.  If the presentation is by a group of individuals, the individuals must decide among themselves who will receive the free registration.  All other presenters must register for the convention and pay the appropriate registration fee. 

 Deadline:  Deadline for submission is February 16, 2007. 

 Send to:

          Donita Qualey, MN, RN

          Delgado Community College

          Charity School of Nursing

          450 South Claiborne

          New Orleans, LA  70112

           Phone# 504 568-5624

          Email: dquale@dcc.edu

          Fax:  504 568-5494

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Louisiana State Nurses Association

BIOGRAPHICAL DATA FORM

________________________________________________________________________

Check the appropriate Category(ies).

 _____  1.  Person administratively responsible                              _____  4.  Presenter

_____  2.  Planning Committee Chair                                                _____  5.  Nurse Planner

_____  3.  Planning Committee Member (specify all roles)           _____  6.  Other: _____________________

                   A)  Target Audience _____

                   B)  Content Expert _____                                               

                   C)  Administratively responsible person  _____  ____________________________________________________________________________________

 Instructions:  Type information directly on a copy of this form.  Do not attach any additional material.

Name: _______________________________________________________________________________

                (Name, Degree and Credentials)

Home or Business Address:  ______________________________________________________________

                                                     (Number & Street)                                                                              (City, State, Zip)

Daytime Phone: _______________________  Email Address: ___________________________________

Present Position (title) & Employer: ________________________________________________________

Position Description:  ___________________________________________________________________

EDUCATION (including basic preparation through highest degree held)

 Planners: (Describe your familiarity with the target audience.)

Presenter: Describe your expertise in this topic:

______________________________________________________________________________________

Vested Interest of Presenter

Having an interest in an organization does not prevent a speaker from making a presentation, but the audience must be informed of this relationship prior to the start of the activity.  (If the applicant already has special forms to identify this, it does not need to be repeated on the bio form.  Include the applicant’s copy of the completed forms declaring vested interest.)

 I recognize that I must follow all guidelines and criteria regarding vested interest.  Any real or perceived conflict of interest for a conference participant must be disclosed.  For this purpose, a real or apparent conflict of interest is defined as having a significant financial interest in a product to be discussed directly or indirectly during the presentation; being or having been an employee of a company with such financial interest and/or having had substantial research support by an industry to study the product to be discussed at the presentation.

 _____  I have no real or perceived conflicts of interest that relate to this presentation.

_____  I have the following real or perceived conflicts of interest that related to this presentation.

 Signature  ______________________________________   Date  _______________________________

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