CALL FOR PROPOSAL SUBMISSION FORM - 2025 Wilderness Symposium/Utah Regional

CALL FOR PROPOSAL SUBMISSION FORM

2025 Wilderness Symposium and Utah Regional Conference | June 2-4 | Zermatt Resort
Thank you for your interest in presenting at the Wilderness Symposium and Utah Regional Conference!

Prospective presenters are invited to submit complete, original presentation submissions using the application below. If you are submitting for multiple topics, complete a form for each topic. Applications must be completed in their entirety, and all information must be present for consideration.

Presenter Responsibilities:
- Payment for your own expenses to attend the conference. Registration fees are WAIVED for Regional Conference presenters.
- Presenters are responsible for registering for the conference (a discount code will be provided upon your confirmation)
- Copies of handouts for distribution
- Providing your own laptop for the presentation
CONFERENCE DETAILS

Presentations will be given on June 3-4 at the Zermatt Resort in Midway, UT.

Presentations will be 1.5 or 3 hours in length, including time for Q&A. 1.5 to 3 CEs will be offered for your presentation if it meets the necessary criteria.
Please select the type of presentation you're submitting:

Standard Presentation (with up to two presenters)Panel Presentation (with one moderator and up to three panelists)Roundtable Discussion (where you are facilitator)
Please select the length of your presentation:

1.5 Hours3 Hours
Primary Presenter Name (or Moderator)*

First NameLast NameSuffix
Primary Presenter Organization*
Primary Presenter Job Title *
Primary Presenter Email*
example@example.com
Primary Presenter Education - Degree*
Primary Presenter Education - Major Field of Study*
Primary Presenter Education - Institution*
Primary Presenter Education - Year*
Primary Presenter Additional Education
Second Presenter / Panelist

First NameLast NameSuffix
Second Presenter Organization
Second Presenter Job Title
Second Presenter Email
example@example.com
Second Presenter Education - Degree
Second Presenter Education - Major Field of Study
Second Presenter Education - Institution
Second Presenter - Year
Third Presenter / Panelist

First NameLast Name
Third Presenter Organization
Third Presenter Job Title
Third Presenter Email
example@example.com
Third Presenter Education - Degree, Major Field of Study, Institution, Year
Fourth Presenter / Panelist

First NameLast NameSuffix
Fourth Presenter Organization
Fourth Presenter Job Title
Fourth Presenter Email
example@example.com
Title of Presentation *
Presentation Track*

AcademicBusiness / AdministrationClinicalTransition / Direct Care
Please type or copy and paste your 100-word session description below:*
Please type or copy and paste your session abstract below:*
Learning Objective 1: (required)*
Learning Objective 2: (required)*
Learning Objective 3: (required)*
Journal / Article Reference 1: (not required for business/admin presentations - please put 'N/A')*
Journal / Article Reference 2: (not required for business/admin presentations - please put 'N/A')*
Journal / Article Reference 3: (not required for business/admin presentations - please put 'N/A')*
Please upload the speaker resumes here (one for each presenter/panelist is REQUIRED).

Cancelof
Signature

Clear
Date

MonthDayYear
Date
Should be Empty: