Critical Care: Our Kaleidoscope

DYNAMICS 2011

Canadian Association of Critical Care Nurses
London Convention Centre, London, ON
October 16 to 18, 2011

POSTER PRESENTATION INFORMATION REQUIREMENTS FORM

ABSTRACT #

GENERAL INFORMATION:

Please fill out the following information; it will help us keep presenters’ information organized. List the oral abstract presentation title along with the first and last name(s) of authors who will be participating in your presentation at the conference:

ABSTRACT TITLE:

PRESENTERS ATTENDING DYNAMICS 2011:

Name

REGISTRATION DETAILS

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·  All authors attending Dynamics 2011 are required to register for the conference.

·  Tuition coupons are valid on EARLY BIRD REGISTRATION only. REGISTER EARLY!

·  Conference Registration Deadlines:

o  Early Bird Registration closes September 2, 2011

o  Final registration closes October 3, 2011

We are unable to hold spots for authors and spaces have sold out in the past. You may register for the conference using the registration form located in the brochures received in your package. Photocopies of the form are also acceptable and are available at www.caccn.ca. Online registration will also be available by early to mid July 2011 at www.caccn.ca.

RELEASE OF INFORMATION:

Due to the Privacy of Information Laws, we require your signature in order to publish your contact information in our conference syllabus. Please have the primary contact person for your presentation fill out the Release of Information section.

Name:

Address:

City: Province:

Postal Code: Email:

Telephone: Fax:

Signature:

SYLLABUS KEY POINTS:

Dynamics 2011 will be providing delegates with a pocket-size Syllabus. The concept of the pocket syllabus is for the delegates to take key points of the presentation back to the bedside and incorporate into their daily practice. Each presenter is asked to provide a page for the syllabus offering their presentations “gems of wisdom”. Please feel free to include website references that may be considered helpful. Please review sample format.

HANDOUTS:

Handouts will not be printed for Dynamics 2011; however those provided will be available on the CACCN website following the conference. Presenters are welcome to bring handouts of their presentation if they wish.

Please check ONE of the following Options:

I/We will be providing handouts to be posted on the CACCN website

I/We will not be providing hand outs to be posted on the CACCN website

For questions, please contact CACCN National Office at:

or toll free 1-866-477-9077

Please submit ALL requested information to:

or by facsimile to 519-649-1458

by no later than August 31, 2011

Dynamics 2011 Presenter Information Form