Application For Presentation - Health Workforce Diversity Regional Conferences

THIS PAGE BECOMES INACTIVE 07/13/07 AND VISIBLE FOR INFORMATION ONLY

I would like to submit an abstract for the following conference(s):

Please check the city/cities which you would like to be considered for:

My abstract would be most appropriate as:

Presentation Checklist

In order for the planning committee to organize the conferences to ensure all grant topics are addressed, we ask that you complete and submit the following checklist. Please check all categories that apply to your proposed research-oriented or best practices presentation and/or poster display.

Note: Check all categories that apply to your presentation abstract.

A. Target audience

Policy development/Health workforce policy K-16 student stakeholdersHigher education
State workforce developmentDepartment of LaborState agencies
Health employers/industryCommunity organizations

B. Ethnicity

African AmericanAsianHispanicNative American
BorderEconomically disadvantagedInner cityRural

C. Health care professions

Allied health - Physical therapyAllied Health - Occupational therapyAllied health - Respiratory therapy
Allied health - OtherAllied health - Biomedical sciencesDentistry
MedicineNursingPharmacy
Public healthOther

D. Components of the health care education continuum

Identifying and assessing underrepresented studentExploring/Investigating health care professions
Improving academic preparation K-16Selecting a health profession program
Applying to health profession program(s)Pre-matriculation and application support
Excelling in standardized assessmentSupporting students to ensure successful higher ed
Supporting entry to the health workforce

E. Issues/Problems/Challenges to improving the diversity of health care students

Improving the quality of K-16 education (math/scie
Creating opportunities for K-16 students to identi
Ensuring teachers and counselors have access to in
Increasing the graduation rate of under represente
Eliminating/Lessening financial barriers to advanc
Lessening the need to work while attending college
Covering living expenses while pursuing health pro
Addressing language barriers including formal lang

F. Practice retention factors

Community engagement/involvement during first yearControl of practice
Professional development opportunitiesRecognition
CompensationFamily quality of life
Embracing cultural competencies in - Higher educatEmbracing cultural competencies in - Employers/Emp

Presentation Title:

Primary Presenter:

Name:		Professional Initial:
Organization/Affiliation:		Mailing address:
City:		State:
Zip:		Telephone:
FAX:		Email:
Biographical sketch (short paragraph) submitted for each presenter may be used for the conference program, application of continuing education and introduction(s) should your presentation be accepted.

See below for additional presenters

Please list two or three measurable learner objectives: At the completion of your presentation attendees will be able to:

Objective 1:
Objective 2:
Objective 3:

Abstract:

My/Our audio visual needs are:

Click on submit button to submit your completed registration. A confirmation email will be sent to the email address you submitted within 24 hours. If you do not receive a confirmation email within 24 hours, please contact Lynn Heimerl at diversityconferences@capitalahec.org. Please print the confirmation for your records.

Additional presenters:

Name:		Professional Initial:
Job Title:		Organization:
BIO

Name:		Professional Initial:
Job Title:		Organization:
BIO