Charter Oak Conference Speaker Confirmation

Please assist us with some administrative details for your presentation. We appreciate your assistance with completing this required information.

Charter Oak Conference Speaker Confirmation Form

Name - Please give your full name and credentials as they should appear in conference materials(Required)
Please select what day you prefer to present by selecting ONE first choice and ONE second choice options. We do our best to accomodate all requests. If you are presenting a pre-recorded session, please select the option "Pre-recorded session speaker"(Required)
Honorarium Selection: Please choose one of the options below. Please note: Speakers provided by AAPA or another pre-accredited educational organization do not need to complete this, as payment is made directly by the contracting entity.(Required)
ConnAPA will make your slides available as a PDF to all registered attendees through our mobile app. Do you authorize us to share your slides as a reference for attendees?
Max. file size: 200 MB.
Max. file size: 200 MB.
If you didn’t include a headshot with your initial submission, please upload a headshot or high-quality photo for our program.
Accepted file types: jpg, jpeg, png, gif.