Student Table Clinic & Research Poster Sessions - 2016

Student Table Clinic/Poster Session Application Submission

Program Details:
Takes place during ADHA's 2016 CLL at the 93rd Annual Session in Pittsburgh, PA

Wednesday, June 8 -  3:00pm - 4:00pm: Poster/Table Clinic Setup 
Wednesday, June 8  - 4:00pm - 6:00pm: Judging 

Thursday, June 9 - 9:30am - 10:30am: Awards Breakfast
Thursday, June 9 - 11:00am - 1:30pm: Open viewing attended by presenters
Thursday, June 9 - 1:30pm - 4:30pm: Open viewing not attended by presenter
Thursday, June 9 - 4:30pm: Pick up presentations
How did you hear about the student table clinic/poster session program? *
Will you be presenting a TABLE CLINIC or RESEARCH POSTER? *
School Name: *
Presenter #1 First Name: *
Presenter #1 Last Name: *
Presenter #1 ADHA Member Number: *
Address (Line 1) *
Address (Line 2)
City *
State *
Zip: *
Cell Phone: *
Email Address: *

Are there additional presenters? *
Additional Presenters: List the names of the additional presenters below:
Additional Presenter #2: First Name
Additional Presenter #2: Last Name
Additional Presenter #2: ADHA Member Number
Additional Presenter #2: Email Address

Additional Presenter #3: First Name
Additional Presenter #3: Last Name
Additional Presenter #3:ADHA Member Number
Additional Presenter #3: Email Address

Additional Presenter #4: First Name
Additional Presenter #4: Last Name
Additional Presenter #4: ADHA Member Number
Additional Presenter #4: Email Address

Please indicate one presenter as the main contact who will receive correspondence from ADHA regarding payment and registration. The main contact can be any of the presenters listed. This person will be responsible for the payment required to participate in the Table Clinic/Research Poster competition. For more information, click here.
Main Contact: First Name
Main Contact: Last Name
Main Contact: Email Address
Main Contact: Phone Number