2nd Annual NC Crisis Summit - Presenter Application
If you are interested in presenting at this year's NC Crisis Summit, please complete the form below. We are interested in a variety of topics to include clinical practice in mental health and substance use, youth and families, crisis response, situational awareness, collaboration and team building, program design and development, data analysis, budgeting, and more! Presentations can have up to 3 total presenters, however, only the main presenter will receive free event registration if selected.
Name
*
First Name
Last Name
Agency/Organization
*
Role/Title
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Presentation Title
*
Summary of Presentation (250 words or less)
*
Identify 3 learning objectives of your presentation
Have you presented at the NC Crisis Summit before?
*
Yes
No
Co-presenter #1 (if none, type "NA")
*
Co-presenter #2 (if none, type "NA")
*
Submit
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