As it will appear on all conference printings. The title MUST be exactly the same title as on the attached document file, and no more than 75-100 characters in length.
I confirm that the date and time for the presentation are correct, as communicated to me in the confirmation email.
Contact Information for Lead Presenter
Curriculum Vitae
Click browse button to navigate and select document file for attachment. Please attach the CV of the lead presenter ONLY.
Please choose your file, but DO NOT click the Upload button.
Files must be less than 20 MB.
Allowed file types: txt rtf pdf doc docx.
Financial Disclosure
ATSA is pursing Continuing Medical Education (CME) credits for the 2017 ATSA conference. It is the policy of the University of Minnesota Office of Continuing Professional Development to ensure balance, independence, objectivity and scientific rigor in all of its educational activities. All individuals (including spouse/partner) who are speaking at the conference are required to disclose to the learners any financial relationships with a commercial interest related to the subject matter of this activity. A commercial interest includes, but is not limited to, psychological tests, software, devices, and guides or workbooks, as well as any entity producing, marketing, re-selling, or distributing health care goods or services consumed by or used on, patients. Disclosure information is reviewed in advance in order to manage and resolve any possible conflicts of interest. Specific disclosure information for each presenter, activity director, and planning committee member will be shared with the learner prior to the presenter's presentation. Persons who fail to complete and sign this form in advance of the activity are not eligible to be involved in this activity. Please upload the completed and signed form for each presenter in your session. If you experience problems uploading the form/s please email this directly to: kelly@atsa.com
Please choose your file, but DO NOT click the Upload button.
Files must be less than 5 MB.
Allowed file types: jpg jpeg tif rtf pdf doc docx.
Please choose your file, but DO NOT click the Upload button.
Files must be less than 5 MB.
Allowed file types: jpg jpeg tif rtf pdf doc docx.
Please choose your file, but DO NOT click the Upload button.
Files must be less than 5 MB.
Allowed file types: jpg jpeg tif rtf pdf doc docx.

If you have designated co-presenters for your presentation, please confirm their availability to attend and intent to present at the conference and have their contact information available for entry before submitting this form.

Contact Information for Co-Presenter #1
All fields are required if presentation includes a co-presenter. The co-presenter has agreed to attend the conference.
Contact Information for Co-Presenter #2
All fields are required if presentation includes a co-presenter. The co-presenter has agreed to attend the conference.
Requirements for Continuing Education Credit
The professional organizations (e.g. American Psychological Association, National Association of Social Workers, National Board for Certified Counselors, etc.) now require that in order to qualify as a valid educational activity, we must document that the following requirements have been met: That presenters have appropriate background and expertise in the topic area. That specific learning objectives have been identified and that these objectives are met in the presentation. That there is some objective measure to assess the achievement of these objectives and the teaching effectiveness of the faculty. Please enter three goals/learning objectives. Learning goals or objectives should clearly define what the participant will know or be able to do as a result of having attended the program. Each Learning Goal should start with, "Upon completion of this educational activity, learners should be better able to..." All three fields are required.*
Please enter three post presentation questions (including answers) related to the goals/learning objectives.
Answers must be True/False, Yes/No, or as a Likert Scale: Strongly disagree (answer 1) to Strongly agree (answer 5). Please do not submit multiple choice, open-ended or essay questions. All three fields are required.*