2015 CALL FOR PRESENTERS The Connecticut Regional EMS Councils would like to invite you to submit to be part of The Connecticut EMS Expo being held May 27- 30, 2015 at Mohegan Sun Resort Casino. SUBMISSION DEADLINE IS NOVEMBER 1, 2014 ■ CONFERENCE INFORMATION ■ PROPOSAL TO PRESENT The EMS Community in Connecticut consists of over 20,000 dedicated volunteers and career EMS professionals, responding to more than 500,000 calls for assistance annually. It is our hope that you will partner with us in our efforts to provide a great educational experience and Expo for all members of the EMS community. If you are interested in presenting at the 2015 CT EMS Expo you must have your materials submitted by November 1, 2014. There will be pre-conference sessions on Wednesday & Thursday. The Expo commences on Friday morning with multiple tracks of interest and will end on Saturday late afternoon. The Expo will provide a broad range of continuing education hours, an exhibitor hall with a variety of EMS representatives, and several social events for networking opportunities. ■ POTENTIAL EDUCATION TRACKS        BLS/First Responder ALS General Pediatrics Preparedness Leadership Training & Education ■ CONFERENCE INFORMATION All presentation rooms will be provided with:  LCD Projector  Screen  Microphone 1 2015 CT EMS Expo | Call for Presenters All proposals must include the following:  Completed Application  Honorarium Requested  Publicity Photo  Resume  Short Biography Your proposal may be submitted via email, [email protected]. All proposals will be reviewed by the CT EMS Expo Speaker Committee. Incomplete proposals will NOT be considered. ■ HONORARIUMS The CT EMS Expo Speaker Committee will make all final decisions on negotiated honorariums. Meals and miscellaneous expenses should be included in the requested honorarium amount. All honorariums are open to negotiation. ■ TIMELINE Proposal submissions will be acknowledged within 5 business days by email. All submissions will receive individual notification of decision by 12/15/14. 2015 PRESENTER APPLICATION All speakers must complete this application. Name: _____________________________________________________________________ Address: ____________________________________________________________________ City/State/Zip: _______________________________________________________________ Cell Phone: _______________________ Home/Office: ______________________________ Email: ______________________________________________________________________ Certifications and Credentials: __________________________________________________ __________________________________________________________________________ __________________________________________________________________________ DATE(S) AVAILABLE (Check all that apply) PRE-CON AVAILABILITY □ Wednesday - May 27, 2015 CONFERENCE AVAILABLITY □ Friday - May 29, 2015 □ Thursday - May 28, 2015 □ Saturday - May 30, 2015 HONORARIUMS □ Honorarium requested per session $ __________ □ Honorarium requested per speaking day $ __________ □ Other __________________________________________________________________ __________________________________________________________________________ 2 2015 CT EMS Expo | Call for Presenters 2015 PRESENTER INFORMATION Please complete one form for each presentation and submit with Presenter Application. Please note that general sessions are 75 minutes. If you have the description and objectives in another document, you may attach in Word Format. Presenter Name: __________________________________________________________________________ Presentation Title: ________________________________________________________________________ Presentation Phrase (3-5 words): __________________________________________________________ __________________________________________________________________________________________ Presentation Description: _________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Presentation Objectives: 1. _______________________________________________________________________________ 2. _______________________________________________________________________________ 3. _______________________________________________________________________________ Educational Track (check all that apply): □ BLS/First Responder □ ALS □ General □ Pediatric 3 2015 CT EMS Expo | Call for Presenters □ Preparedness □ Leadership □ Training and Education