EmailMe Form - 2025 NAFC Symposium Speaker Application

Presenter Name *

First Last

Presenter Organization *

Degree(s)/ Credentials

Title

Mailing Address *

Street Address City State / Province / Region Postal / Zip Code

Presenter Cell Phone Number *

### - ### - ####

Presenter Email *

Presenter Headshot *

Brief Presenter Bio (max 150 words) *

My Proposed Educational Session will be a:

Breakout Seminar Session: A 50 minute presentation with 10 minutes for questions & answers

Breakout Co-Presenter (2 presenters max): A 40 minute co-presented presentation with 20 minutes for audience participation and questions

Interactive Moderated Session

In addition to your proposed session, would you be open to facilitate a discussion at the Symposium?

No, thank you.

Yes, I am open to facilitating any discussion if needed.

Yes, I am open to facilitating a discussion on the following topic: (ex. fundraising, new directors, data collection, etc.)

My organization is a (check all that apply):

Please select the budget range that is closest to your organization's budget.

Educational Topic Area for Presentation: (example - "Food as Medicine" or "Grantwriting") *

This session is a great fit for (Please select only two):

Have you previously given this presentation at another conference?

Yes

No

Have you previously presented at a NAFC Symposium?

Yes

No

Why would you like to present at the NAFC Symposium? *

Regarding the NAFC's General Session:

Please select all types of speakers you would be interested in hearing from at the meeting:

TED Talk Stories from NAFC Members

Paid Motivational or Educational Speaker

Panel of Funders

Other

Please select all that apply: *

I can attend the Symposium and present live

I cannot attend the Symposium in-person, but would like to pre-record a virtual session

I would be willing to pre-record this session in addition to the live presentation in-person

Co-Presenter Name

First Last

Co-Presenter Organization

Degree(s) / Credentials

Title

Co-Presenter Cell Phone Number

### - ### - ####

Co-presenter Email

Brief Co-Presenter Bio (max 150 words)

Co-Presenter Headshot

Please select the budget range that is closest to your organization's budget if different from the first presenter.

PART II: Abstract Description & Summary

Abstract Title:

Provide a catchy title which will entice people to attend your session. (For planning purposes and accreditation regulations, your presentation title cannot be changed without approval) max 50 words. *

Abstract Summary:

Describe what issue and solutions the session will address. This will be published in the preliminary program if the session is accepted. (max 150 words) *

Presentation Focus:

Please provide more detail for the review Committee on what the specific focus will be of your proposed presentation. (max 250 words) *

PART III: Objectives and Content

State the purpose of the activity in terms of enabling the participant to do something that can be measured. A learning objective should begin with an active verb that completes the statement, “Upon completion of this activity, participants will be able to ...” followed by a short description of what specifically the participant will know or be able to apply to their organization after the activity. Avoid words that are subject to interpretation or that denote activities that are subjective.*

*These verbs should be avoided since they are open to interpretation and not measurable:
Appreciate, Enjoy, Hear, Perceive, Be aware of, Explore, Know, Realize, Behave, Grasp the significance of, Learn, Understand, Believe, Have faith in

Reference the following list of verbs to formulate learning objectives.

Information Verbs:
Cite, Identify, Quote, Relate, Tabulate, Count, Indicate, Read, Repeat, Tell, Define, List, Recite, Select, Trace, Describe, Name, Recognize, State, Update, Draw, Point, Record, Summarize, Write

Comprehension Verbs:
Assess, Contract, Distinguish, Interpolate, Restate, Associate, Demonstrate, Estimate, Interpret, Review, Classify, Describe, Explain, Locate, Translate, Compare, Differentiate, Express, Predict, Compute, Discuss, Extrapolate, Report

Example: The participant will be able to recognize symptoms of X disease.

1. The participant will be able to: (max 75 words) *

2. The participant will be able to: (max 75 words) *

3. The participant will be able to: (max 75 words) *

Expected Outcome:
What is the expected outcome for attendees? (max 150 words) *

Presenter Responsibilities/Requirements

In an effort to assure presentation descriptions represent the full concept of the presentation, and to assure ample information is available to all, the session presenter will be asked to sign a presenter agreement contract. The presenter(s) agree(s) to the following responsibilities:

• Speakers will abide by the NAFC conference code of conduct.

• The NAFC reserves the right to interview applicants and review PowerPoint Presentation slides prior to selection of the speaker.

• Speaker(s) will be available for presentation on any of the conference dates. There is no negotiation with regard to placement on conference agenda.

• Speaker(s) will register for the conference (the NAFC typically offers a reduced registration fee for speakers).

• Speaker(s) agrees to comply with all requirements, including but not limited to presentation deadlines, conflict of interest forms, presentation information, biography requirements and terminology. The speaker understands that without compliance with these requirements, the NAFC reserves the right to remove the presentation from the agenda.

• Speaker(s) will provide the NAFC with electronic PowerPoint versions of the presentation and/or electronic files by September 5, 2025, prior to the conference, for review, approval and placement on the attendee portal.

• Speaker will agree to an audio recording of their session, possible live video streaming of their session, and placement of audio recording, presentation and handouts online.

• Speaker(s) will provide an adequate number of handouts for their presentation if applicable.

• Speaker(s) will communicate any changes from the initial abstract to the NAFC staff lead.

• Speaker(s) will utilize the approved NAFC presentation format.

• Once approved by the NAFC, the Speaker(s) shall present on the sessions agreed upon.

• The NAFC reserves the right to work with the speaker(s) to ensure that the material presented meets the agreed upon agenda session.

• Abide by the dates in the Agreement.

• Not defame, slander or libel any person, firm or corporation.

• Present sessions according to NAFC Professional Standards, and shall not denigrate the NAFC, its programs or representatives in any manner.

• Agree and state that all materials and content presented by the Speaker(s) do not infringe upon or violate any copyright, trademark, patent or intellectual property rights of any person or entity, nor do they promote or endorse any product, service, or device which may or is at the time of the program not approved by any governing agency.

• Agree to all NAFC policies, procedures and statements, including but not limited to: Conflict of Interest, Anti-Trust, Equal Opportunity and Ethics.

Merchandising: Speaker shall not sell or promote any particular product or service at any time during the session presentation.

Speakers offering services or products are welcome to become an exhibitor at the NAFC Symposium and should contact the NAFC directly for those speaking sessions that may be available for service/product providers.

Cancellation: The NAFC reserves the right to cancel this Agreement and replace Speaker(s) if due dates are missed. The NAFC reserves the right to cancel any session, change the length or size of any session, or change the place of any session at its discretion at any time. If Speaker(s) desire(s) to cancel, Speaker(s) agrees to provide thirty (30) days written notice of cancellation prior to their first scheduled session.

Audio-Visual: The NAFC will provide a laptop, LCD projector, screen, and microphones in the breakout session rooms.

All applications must adhere to the guidelines. Incomplete applications will not be considered. A separate application must be completed for each submission.

Companies/Organizations that offer products and or services for sale should contact the NAFC at ariana@nafcclinics.org for information on speaking opportunities.

Date *

MM / DD / YYYY

I agree to the terms and responsibilities outlined in this abstract submission form *

Yes

Signature *

Clear

Please sign your name above using your mouse in the space above.