FEATURE PRESENTATION
Proposal Submission Form
42nd Annual SEATA Clinical Symposium &
Members Meeting, Atlanta, GA
March 10-12, 2017
Complete the submission form by providing requested information in the text fields. Please refer to the Feature Presentation Guidelines for information regarding this format.
Submit (email) completed submission form and all required materials to:
Brady L. Tripp PhD, ATC
SEATA Research and Education Committee Co-Chair
Title of presentation:
Length of presentation: Willing to be considered for an EBP session? Yes No
Note: Presentation length is 1-1.5hours with up to 3 speakers.
Speaker 1(name & credentials):
Subtitle of presentation (if applicable):
Title or position:
Place of employment:
Address:
Email:
Work Phone:Cell Phone:
NATA Member: YesNoNATA Member #:
Attach CV (word document or PDF) with submission form
Speaker 2(name & credentials):
Subtitle of presentation (if applicable):
Title or position:
Place of employment:
Address:
Email:
Work Phone:Cell Phone:
NATA Member: YesNoNATA Member #:
Attach CV (word document or PDF) with submission form
Speaker 3(name & credentials):
Subtitle of presentation (if applicable):
Title or position:
Place of employment:
Address:
Email:
Work Phone:Cell Phone:
NATA Member: YesNoNATA Member #:
Attach CV (word document or PDF) with submission form
Learning objectives: Provide a minimum of 3 (i.e., “Attendees will be able to explain…”)
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Method for assessing objectives: Formal written assessment Discussion
Purpose, Knowledge, Competency, or Performance Gap Addressed by Session:
Educational materials offered to participants? (outline, PowerPoint, etc.)
References/sources: List 3-5 sources used in the development of the proposal/presentation. Utilize format as described in the Journal of Athletic Training author’s guide:
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Proposals must be submitted no later than October 1, 2016.
Incomplete and/or late proposals will NOT be accepted.
THANK YOU FOR YOUR SUBMISSION!
Abstract (100 words or less):
Domain(s) of Athletic Training: Select all that apply to the proposed presentation
I-Injury/Illness Prevention and Wellness Protection
II-Clinical Evaluation and Diagnosis
III-Immediate and Emergency Care
IV-Treatment and Rehabilitation
V-Organizational and Professional Health and Well-Being
Educational Level of Presentation: Identify educational level for overall presentation.
EssentialAdvancedMastery