WIPM 2025 Topic & Faculty Suggestions AND Nominations for Women-Focused Charitable Organizations
Deadline to Submit - August 31, 2024
Name
*
First Name
Last Name
Credentials
*
Please Select
MD
DO
PhD
NP
PA
RN
PA-C
MBA
MD, PhD
MD, MS
MD, MBA
MS
MD, MPH
DO, MPH
MD, FASA
PsyD
AMP
FNP
MPAS, PA
PA
BA
MSN, FNP
BS
DNP
None
Other
Email
*
example@example.com
2025 Topic & Faculty Suggestions
Suggested Topic
Learning Objective
Suggested Faculty/Panelists (Name and Email)
I'd like to be considered to present this topic
Additional Comments
Your Nomination for a Women-Focused Charitable Organization
This will be announced at the Gala Event held at the 2025 Annual Conference
Women-Focused Organization Name
Women-Focused Organization Website
Why are you nominating this Organization?
Any Additional Details
Submit
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