Call For Proposals & Posters

Conference Dates: Placeholder

Location: Virtual - Zoom Events

Part 1 - Contact Information
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Email*
example@example.com
Membership *

Part 2 - Proposal Information
Proposal Type

Speaker PresentationPoster
Topic of Presentation or Poster*
Conference Track Area*
See here for our four tracks and topic examples.
Proposal*
Please provide three learning objectives written at an introductory level (Knowledge and Comprehension level). If you are looking to be on a panel, you can put N/A here.*
Click here for examples of how to write learning objectives
File Upload (Picture and Bio)*

Cancelof
Our conference is held over two days, each day running from 10 AM to 5 PM Eastern Standard Time. Please let us know your general preferences on time and dates, and we will do our best to accommodate. Example: I am on Mountain Time, and can present either day with a preference of morning and early afternoon.*

Part 3 - Financial Disclosure
What is you role in this educational activity? Check all that apply.

AdministratorPlanning Committee MemberPresenter / Content Specialist
Conflict of Interest Disclosure

Having an interest in an organization does not prevent a presenter from making a presentation. Still, the audience must be informed of this relationship before the start of the activity, and any potential conflict must be resolved.

All planners, faculty, and content specialists participating in this education activity must disclose to the audience any of the following:

• Relationship with companies who manufacture products or provide services used in the treatment of the subjects under discussion in the educational activity.

• Relationship between the planner, faculty or content specialist and commercial supporter(s) of the activity.

• Intent to discuss unlabeled uses of a commercial product, or an investigational use of a product not yet approved for this purpose. All information disclosed must be shared with the audience either on the program handouts, advertising and/or audiovisual presentation.

Financial Relationships - those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, gift, speaking fee, consulting fee, honoraria, ownership interest (e.g., stocks, stock options, or other ownership interest, excluding diversified mutual funds), or other financial benefit. Financial relationships can also include "contracted research," where the institution gets the grant and manages the funds, and the individual is the principal or named investigator on the grant.

Program Planners/Instructional personnel have a relevant financial relationship if that relationship could influence the information presented in the course and could be perceived as a conflict of interest by learners.
Do you have relevant financial relationships to disclose?

YesNo
Nonfinancial relationships - relationships that might bias an individual including any personal, professional, political, institutional, religious or other relationship.

Program Planners/Instructional personnel have a relevant non-financial relationship if that relationship could influence the information presented in the course and could be perceived as a conflict of interest by learners.
Do you have relevant non-financial relationships to disclose?

YesNo
Professional Behavior:

As a presenter/instructor I will demonstrate high standards of professional conduct and do not discriminate against learners on the basis of gender, age, socioeconomic or ethnic background, sexual orientation, or disability.

I am stating that the information recorded here is true to the best of my knowledge and reflective of my intentions. I agree that it is my professional responsibility to ensure an accurate report of my disclosures(s).

I attest that the information in this disclosure is accurate at the time of completion and I agree to notify Infant Massage USA if this changes.

Part 4 - Recording Agreement
Infant Massage USA holds our conference on-line using the Zoom Events platform. All sessions will be recorded for future educational purposes for IAIM and Infant Massage USA - including but not limited to YouTube playlists, monthly newsletters, and replays for our members.

By submitting your proposal you understand and agree to this recording agreement. Further questions and clarfication can be discussed with the executive director, Ashley Febvay, at anytime via email - ashley@infantmassageusa.org.
Should be Empty: