AADPRT Virtual Session Request Form

AADPRT VIRTUAL SESSION REQUEST FORM
- All sessions occur on Fridays at 12pm ET.
- Session must be requested at least three (3) weeks in advance.
- Submission of this form does not confirm your date. AADPRT staff will reach out within one week to confirm your date.
- Session will be conducted via the AADPRT Zoom account. Login information will be provided to the form submitter upon confirmation of date.
- Zoom functionality available to all presenters includes:
  - Screen share
  - Breakout rooms
  - Polling
  - Chat
- Following your workshop, please send to exec@aadprt.org any materials you'd like uploaded to the VTO.
Virtual Session must meet one of the following requirements:*

Workshop led by AADPRT Training Director Committee/CaucusWorkshop led by AADPRT Program Administrator (Coordinator) Committee/CaucusConsultations led by AADPRT Training Director Committee/CaucusConsultations led by AADPRT Program Administrator (Coordinator) Committee/CaucusWorkshop presented at a past AADPRT Annual Meeting
Workshop audience (check all that apply)*

TD/ATDPA
AADPRT Committee Name*
Session Title (e.g. NTD Virtual Forum, Mentorship Consultations, Workshop Title, etc.)*
Session Description (we'll use this to market the session)*
Presenter Name (Suffix = MD, DO, C-TAGME, etc.)*

First NameLast Name
Email*
example@example.com
Do you have fellow presenters?*

YesNo
Fellow Presenter (Suffix = MD, DO, C-TAGME, etc.)*

First NameLast Name
Fellow Presenter (Suffix = MD, DO, C-TAGME, etc.)

First NameLast Name
Fellow Presenter (Suffix = MD, DO, C-TAGME, etc.)

First NameLast Name
Fellow Presenter (Suffix = MD, DO, C-TAGME, etc.)

First NameLast Name
YOU MUST REVIEW THE AADPRT CALENDAR before selecting a date(s) to be sure they're available. Subscribe to the AADPRT shared calendar below or view it on the website for open dates. All virtual Sessions occur ONLY on Fridays at 12pm ET (only one virtual session per Friday).

Calendar subscription instructions:

Click AADPRT shared calendar.
Open the .ics file that downloads to your computer. This will load the AADPRT calendar to your computer's calendar software (e.g. Outlook).
You can turn this calendar off and on at any time.
Or, view it on the website.
Session Duration*

1 hour1.5 hours
I want to host my session on multiple dates*

YesNo
Friday Date Request*

MonthDayYear
Date
Alternate Friday Date Request (for this session - not recurrence)*

MonthDayYear
Date
2nd Alternate Friday Date Request (for this session - not recurrence)*

MonthDayYear
Date
1st Presentation Date (Fridays only)
Friday Date Request*

MonthDayYear
Date
Alternate Friday Date Request (for this session - not recurrence)*

MonthDayYear
Date
2nd Alternate Friday Date Request (for this session - not recurrence)*

MonthDayYear
Date
2nd Presentation Date (Fridays only)
Friday Date Request*

MonthDayYear
Date
Alternate Friday Date Request (for this session - not recurrence)*

MonthDayYear
Date
2nd Alternate Friday Date Request (for this session - not recurrence)*

MonthDayYear
Date
3rd Presentation Date (Fridays only)
Friday Date Request

MonthDayYear
Date
Alternate Friday Date Request (for this session - not recurrence)

MonthDayYear
Date
2nd Alternate Friday Date Request (for this session - not recurrence)

MonthDayYear
Date
Do you have poll questions?*

YesNo
Please type your questions and answer options (multiple choice).*
Do you want breakout rooms?*

YesNo
- All sessions occur on Fridays at 12pm ET.
- Session must be requested at least three (3) weeks in advance.
- Submission of this form does not confirm your date. AADPRT staff will reach out within one week to confirm your date.
- Session will be conducted via the AADPRT Zoom account. Login information will be provided to the form submitter upon confirmation of date.
- Zoom functionality available to all presenters includes:
  - Screen share
  - Breakout rooms
  - Polling
  - Chat
- Following your workshop, please send to exec@aadprt.org any materials you'd like uploaded to the VTO.
Should be Empty:

AADPRT VIRTUAL SESSION REQUEST FORM

1st Presentation Date (Fridays only)

2nd Presentation Date (Fridays only)

3rd Presentation Date (Fridays only)