NBS Nursing Taskforce - Webinar Speaker/Topic Survey

1
Your Information* This field is required.
Name
Email
Please Select
Please Select
Nurse
Advanced Practice Nurse, Clinical Nurse Specialist
Advanced Practice Nurse, Educator
Advanced Practice Nurse, Nurse Practitioner
Affiliation
Workplace/Institution Name
2
Which topics would you like to be covered by the Task Force's activities?
3
Would you like to volunteer to give a talk or suggest a speaker to give a talk for our quarterly nurse-led webinars?* This field is required.
Volunteer as a speaker
Suggest a speaker
None
4
Suggest a Speaker* This field is required.
Suggested Speaker's Name
Suggested Speaker's Email
Please Select
Please Select
Nurse
Advanced Practice Nurse, Clinical Nurse Specialist
Advanced Practice Nurse, Educator
Advanced Practice Nurse, Nurse Practitioner
Affiliation
Reason for Nomination
5
What topic would you like to address in your talk?* This field is required.
6
Do you have any additional suggestions on how the task force can improve our educational activities?
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Large
Normal
Small
Ok
Ok
7
Would you like to actively participate in NBS Nursing Task Force activities in the future?NBS members only.
YESNO
Should be Empty: