Poster Abstract Submission Instructions

Submission deadline: July 12th, 2020 (midnight EDT)

Posters approved for presenting must have at least one author with a paid registration attending the conference for the poster to be displayed.

Award recipients will be solely responsible for all federal, state and/or local taxes associated with the scholarship. The first place winner of $1000 will be required to complete an IRS W-9 before receiving payment.

NOTE: If you have multiple authors, COI information must be completed for each author listed on the poster.

NOTE: It is recommended to print the blank submission form to review prior to completing. Once you have started the application it cannot be saved. If this page is closed without submission, all information entered will be deleted.    Print a blank copy of this form now.

Fields with * are required. Complete all other fields as appropriate or enter "N/A" if not applicable.


*Person submitting this form:


     


*Poster /  Abstract Information:


(300 words or less)

Do not include any URLs


     


     


*Author Information:

(Conflict of Interest information is required for each author - complete below. In the event there are more than 10 authors, contact bhe@serwocn.org for additional form)


*Primary Author Name, Contact and Disclosure


(List most current, highest degree first, then licensure and certification credentials)



  

I certify this poster presentation will not suggest or otherwise endorse the use of any products. I understand my presentation may be included in a conference summary or be used in other ways deemed appropriate by the Southeast Region of the WOCN® Society.

 
 

Conflict of Interest Disclosure (Primary Author)

     
  

   

      

      

   
     



     


     

  
   (List most current, highest degree first, then licensure and certification credentials)
     

 
 

Conflict of Interest (Author #2)

   
   


       

       

      

   
     

 
         


     

  
   (List most current, highest degree first, then licensure and certification credentials)
     

 
 

Conflict of Interest (Author #3)

   
   


       

       

      

   
     

 
         


     

  
   (List most current, highest degree first, then licensure and certification credentials)
     

 
 

Conflict of Interest (Author #4)

   
   


       

       

      

   
     

 
         


     

  
   (List most current, highest degree first, then licensure and certification credentials)
     

 
 

Conflict of Interest (Author #5)

   
   


       

       

      

   
     

 
         


     

  
   (List most current, highest degree first, then licensure and certification credentials)
     

 
 

Conflict of Interest (Author #6)

   
   


       

       

      

   
     

 
         


     

  
   (List most current, highest degree first, then licensure and certification credentials)
     

 
 

Conflict of Interest (Author #7)

   
   


       

       

      

   
     

 
         


     

  
   (List most current, highest degree first, then licensure and certification credentials)
     

 
 

Conflict of Interest (Author #8)

   
   


       

       

      

   
     

 
         


     

  
   (List most current, highest degree first, then licensure and certification credentials)
     

 
 

Conflict of Interest (Author #9)

   
   


       

       

      

   
     

 
         


     

  
   (List most current, highest degree first, then licensure and certification credentials)
     

 
 

Conflict of Interest (Author #10)

   
   


       

       

      

   
     

 
         


 

  

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