Wufoo
Session Summary Form
To be filled out by conference planning team member once session plan is complete.
CPT Member Name
First
Last
FINAL Session Title
Prior Session Title (if different)
Track
Confirmed Speaker #1 Name:
Speaker #1 Title & Organization or Affiliation:
Confirmed Speaker #2 name
Speaker #2 Title & Organization or Affiliation:
Confirmed Speaker #3 Name:
Speaker #3 Title & Organization or Affiliation:
Confirmed Speaker #4 Name:
Speaker #4 Title & Organization or Affiliation:
Confirmed Speaker #5 Name:
Speaker #5 Title & Organization or Affiliation:
Issue Description
Objectives. After attending this session, participants will: (Number the objectives.)
Session Summary (For promotion and conference materials; 40-word limit. Include key issues and objectives.)
How will session be presented:
Lecture
Panel
Case Study
Other:
If "Other" please describe:
Moderator:
Moderator Organization or Affiliation:
Moderator Title:
Moderator Email:
Moderator Phone:
Do Not Fill This Out