Call for Presenters

1. Presenter Information

Name of Primary Presenter*

First Last

Credentials / Professional Designations*

(e.g. SRT [student RT], RRT, MSc, CCAA, etc)

Title*

(e.g. staff RRT, manager, etc.)

Place of Employment*

(name of institution or organization)

Work Address*

Street Address Address Line 2 City Province Postal Code Country

Email Address*

Enter Email Confirm Email

(professional or work address preferred)

Daytime Phone Number*

The presenter is a student.*

Yes
No

Brief Presenter Biography*

Your biography will be used to introduce you prior to your presentation. Maximum length: 700 characters

Are you requesting to include additional presenters?*

Yes
No

The CSRT will review all requests for additional presenters and notify the primary presenter if additional presenters have been approved. An additional presenter may be considered if they provide a perspective that cannot be provided or reported on by the primary presenter.

Name of additional presenter

Credentials of additional presenter

Email address of additional presenter

Rationale for including additional presenter

Call for Presenters

Call for Presenters

Step 1 of 3

CSRT 2022 Annual Conference

May 13-14, 2022

Deadline for submission: October 29, 2021.

Instructions (Please read carefully before completing this form.)

1. Presenter Information

2. Presentation Information

Abstract

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