2016 Leg Day poster submission form

Poster Abstract Submission Form

Please fill in the form below.
Call for Posters!

CALLING ALL POSTER PRESENTERS! Share your research, evidence based practice, innovation, or performance improvement at our Legislative Day Poster Session!

Held in conjunction with our Legislative Day on February 16th, our Poster Session is the perfect opportunity to share your work with colleagues from around Virginia. Awards will be given in several categories, including student posters.

STUDENT SUBMISSIONS ENCOURAGED!

Important Dates

January 30 (midnight) - Abstracts due to Selection Committee
February 2 - Accepted poster presenters notified (At least one presenter must attend the conference with an accepted poster.)
February 9 - Registration closes
Primary Presenter *

PrefixFirst NameLast Name
Institutional Affiliation *
Student status?

Full-timePart-timeNot
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
E-mail*
Institution where work was done (if different than above)
Additional Presenter 1 First Name
Additional Presenter 1 Last Name
Additional Presenter 1 Institutional Affiliation
Additional Presenter 2 First Name
Additional Presenter 2 Last Name
Additional Presenter 2 Institutional Affiliation
Category (Select 1)*
Poster Title
Poster Abstract (250 word maximum)

0/250
Resume, CV, or professional bio

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