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?
Yes No
*Quarter/term you would like to present:
Fall Winter Spring
Date Choice (1st)
Date Choice (2nd)
*Is this a proprietary class?
Yes No
If yes, who is sponsoring the class?
Comments:
*Have you presented at Grand Rounds before?
Yes No
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**
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