30th Annual Educational Conference Presentation Submission

Aug. 5th-6th - Hilton Garden Inn -Champaign

Please fill out all fields below.

Deadline: 3/22/19

Questions: Email Margaret Vaughn, staff@ilruralhealth.org, or call (217) 280-0206.

Presentation Title *

Presentation Format: *

Research Presentation

Workshop Session

Panel Discussion

Who is the audience for your presentation? *

Please submit a brief overview of your presentation (75-100 words) *

0/100 words

Presentation Objectives: (For example: After this presentation, participants will be able to…) *

Audio/visual equipment needed: *

Presenter *

Degree (or title) *

Organization *

City *

State *

Zip *

Email Address *

Phone Number *

Attendance *

I plan on attending whole IRHA Educational Conference ($150 if accepted)

I plan on just presenting at the IRHA Conference and staying for a meal (no cost)

Please attach any additional presenter(s) information.