Tri State Black Pride 2022

Tri State Black Pride 2022

Abstract Submission
"Better Together"

People, Purpose and Power
Abstract Submission
Abstracts should be emailed by Friday, June 3, at 5:00pm. Please DO NOT submit multiple copies of the same abstract.

Please complete each field in the form to ensure the best accommodations for your presentation.
Abstract Information (Primary Facilitator)

(Please complete all of the required information - Marked with an *)
Date & Time (Note: Information will pre-populate) *

Month Day Year
Date Hour Minutes AM/PM Option
Name *

Prefix First Name Last Name
Professional Title/Position *
Organization/Affiliation Name *
Email (Note: Please use your primary email to receive official communication) *

Confirmation Email example@example.com
Address (Please use your official address to receive communicaiton) *

Street Address

Street Address Line 2

City State

Zip Code
Phone Number *
Co-Facilitator Information

(Note: Please complete if you have a co-facilitator)
Name

Prefix First Name Last Name Suffix
Email

Confirmation Email example@example.com
Phone Number
Professional Title/Position
Organization/Affiliation Name
Abstract Submission Type

(Please complete all of the required section - Marked with an *)
Type of Submission *

Paper Presentation Panel Presentation Poster Presentation PowerPoint Presentation
Abstract Title *
(Please make sure you give the full title)
Presentation Length of Time *

35 to 40 Minutes 45 to 60 Minutes
Title of Panel (If applicable)
(Please supply a brief description of panel if selected.)
Abstract Accomodations (If applicable) (Note: Due to the pandemic all workshops will be in-person and virtual) *

Wireless Internet Access Power Connection Projector for Presentation Bluetooth Speaker No Accomodations is required
Abstract Upload (Optional)

Browse Files
(Please upload your presentation. If the presentation is not final please upload a summary of your presentation) Cancel of
Abstract Cut and Paste (Optional)
Primary Facilitators Bio and Pic *

Browse Files
(Please make sure you include both bio and picture) Note: Information will only be used for seminar purposes only. Cancel of
Co-Facilitator Bio and Pic

Browse Files
(Please make sure you include both bio and picture) Note: Information will only be used for seminar purposes only. Cancel of
Please choose a date and time that you are available to conduct your presentation. Please note that your date of choice will be TAKEN into consideration. Times may slightly change due to the pandemic. Seminars will be be in-person and virtual this year.

Location: Double Tree by Hilton

5069 Sanderlin Avenue, Memphis Tn 38117

Presentations: In-Person or Virtual Seminars Selection

Available Presentation Time

Friday June 17th
- 9:00am till 9:50am
- 10:00am till 10:50am
- 11:00am till 11:50am
Saturday June 18th
- 9:00am till 9:50am
- 10:00am till 10:50am
- 11:00am till 11:50am
Please select two different days and dates (Primary and Secondary)
Please select your primary date and time to present
Date

Month Day Year
Date
Time

: Hour Minutes AM/PM Option
Please select your secondary date and time to present
Date

Month Day Year
Date
Time

: Hour Minutes AM/PM Option
Very Important Note:

This year will be in-person or virtual for participants and presenters.

Please make sure you bring your own copies of flyers, presentations, or handouts for participants if in person.

If the situation change we will keep you update.
Should be Empty:

Now create your own Jotform - It's free! Create your own Jotform

Tri State Black Pride 2022

Abstract Submission

Abstract Information (Primary Facilitator)

Co-Facilitator Information

Abstract Submission Type