page_title
Fill in the text

Grand Rounds Class Application

Applications take a minimum of two weeks to review. If Continuing Education requirements are requested please submit the application at least six weeks prior to your event date as Boards and Review committees have a longer turn around time to approve Continuing Education Units.

Contact Information
*Contact Person:
*Email Address:
*Mailing Address:
*Phone Number:
Alternate Phone:
Class Information
*Class Title/Topic:
*Presenter Name:
*Are you interested in having your class posted online for CE?
*Quarter/term you would like to present:
Date Choice (1st)
Date Choice (2nd)
*Is this a proprietary class?
If yes, who is sponsoring the class?
Comments:
*Have you presented at Grand Rounds before?
If so, when?
What topic?
Please Include with this Application:
*CV OR BIO CE programs must be presented by qualified professionals per OAR 850-040-0210(2)(b), including NDs and/or professionally recognized health care providers or educators with expertise in the subject matter. Your request must include a bio or curriculum vitae that establish the presenter is qualified to present information on the topic.
*PRESENTATION SUMMARY 120 words or less description of the class.
PowerPoint A PowerPoint of your presentation is requested a minimum of one week prior to your presentation. This can be emailed directly to residency@ncnm.edu
??? QUESTIONS ??? We are available at 503-552-1548 or 503-552-1847, and email residency@ncnm.edu
***THANK YOU, WE LOOK FORWARD TO WORKING WITH YOU**
Upload the following documents (PDF, Word or Excel format only):   
CV or Bio
Presentation Summary