NECHE Presenter Form

First Name

Last Name

Email

Degree (BA, MA, PHD, CHW, RN, Etc.)

Professional Title (Professor, Director, etc.)

Working Title of the Conference Presentation

Brief Summary of the Conference Presentation (less than 300 words)

Professional Bio (less than 300 words)

Please upload a high resolution headshot for promotional materials

Upload File

Upload supported file (Max 15MB)

I accept that the conference will be live streamed and recorded via Zoom. I understand that conference presentations and other materials provided above will be shared online for our registrants.

If you have any questions related to this form, please email info@nehealthequityconference.com and in the subject line, please include "Keynote Form."