Title of Presentation: ____________________________________________

Audio Visual:

________ Slide projector

________ LCD projector

________ Overhead projector

________ Lavalier microphone

________ Pointer

________ Other (specify) ___________________________________

We require 150 copies of handouts. Please bring your handouts with you to the
Workshop. Please submit original plus one file copy by May 1, 2005.

Requirements Checklist - enclosed are the following:

________ Abstract and Abstract Submission Form

________ Speaker Registration Form

________ Presenter objectives and content outline

________ Curriculum Vitae

________ Biographical sketch

________ Consent Form (to audiotape/videotape)

________ Disclosure Form

*Abstracts WILL NOT be accepted without these completed forms and materials *

PLEASE SUBMIT MATERIALS TO:
Dianne Mance, Conference Services Coordinator
National Black Nurses Association
8630 Fenton Street, Suite 330, Silver Spring, MD 20910
Fax: (301) 589-3223