Call for Presentations: Proposal Application

Speaker Information

List all proposed speaker name(s), title(s), facility name(s) and contact information as you would like them to appear in the conference brochure. One complimentary registration will be given per facility per presentation.

Presenter 1
Name
Title
Company
Street
City
State
Zip
Telephone
Fax
Email

Presenter 2
Name
Title
Company
Street
City
State
Zip
Telephone
Fax
Email

Presenter 3
Name
Title
Company
Street
City
State
Zip
Telephone
Fax
Email

Presenter 4
Name
Title
Company
Street
City
State
Zip
Telephone
Fax
Email

Biography (30 words)

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Presentation Information

1. Presentation Title

2. Presentation Abstract
(100-word summary of the subject matter - please include the QuadramMed product(s) that will be covered in the session, for our brochure.)

3. This presentation is best described as one of the following:

4. Including time for Q&A, this presentation requires:

5a. Intended audience:
New User Experienced User

5b. Special Interest Group (SIG): (You may select more than one, if appropriate, using Control/Click.)

6. All presentations should utilize Microsoft Powerpoint, not slides or transparencies. What are your presentation audio/visual requirements?
Conference computer (versus your own laptop)
Other:

7. Has it been or will the presentation be given elsewhere prior to the UG2009 conference?
No Yes. If yes, where?

8. Continuing Education Credit: Please indicate if you feel the content of the presentation is suitable for receiving Continuing Education credit. If yes, you will be required to complete the applicable paperwork from the appropriate credentialing association based on the content of the presentation.
Yes No

9. Please be sure you have filled out the following sections above before submitting this proposal form:

Presentation proposals
100-word abstract for brochure
30-word speaker bio for each speaker

Applicant Agreement

I attest, as an applicant for speaker at the 2009 QuadraMed User Group Conference, that the above information along with the attached documentation is true and correct. I am aware that I give UG and QuadraMed copyright freedom with all papers, presentation materials, and audio/video for my presentation at the conference. I am also aware of UG's policy to not pay travel or lodging expenses for its speakers.

Submit this form and necessary documentation by January 23, 2008.

Please Note: Should you encounter any error messages, please email a screen capture to webmaster@quadramed.com. (Use the Print-screen button on your keyboard to take the screen capture, then, in the body of your message, right-click and select "paste.") We will contact you promptly with further assistance.

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