Podium & Poster Application Form

**Deadline to Apply is January 10, 2027
***Open to NACN-USA Members Only. (Apply Now)

Please note: This submission process includes TWO forms.
Part 1: Complete your personal and presentation information in the form below.
Part 2: After submitting this form (Part 1), you’ll be directed to a second form to upload your CV and professional headshot.

Full Name (including credentials)(Required)

Phone(Required)

Email(Required)

Additional Presenter Names & Credentials, Phone, Email

I verify that the above listed individuals are already a member of NACN-USA, and therefore, elegible to be a conference speaker(s).(Required)

Yes

Presentation Title (75 characters or less)(Required)

Target Audience(Required)

Presentation Summary of Conference Program Listing (Maximum of 150 words)(Required)

Teaching Method(Required)

Podium

Poster

Background

Describe the clinical problem, why the topic is significant and what gap in knowledge exists.

Purpose

State the specific research question, hypothesis, or primary goal of the study.

Methods

Outlines the study design (e.g., qualitative, quantitative), setting, participant sample, and data collection/analysis methods.

Results

Summarizes the key findings, including specific data and statistical significance if applicable.

Conclusions

Provides a brief interpretation of the findings and their overall meaning.

Implications for Practice

Explains how the findings should influence nursing care, policy, or future research.

Background

Summarizes the clinical challenge or controversy that prompted the project.

Model

Specify the framework used, such as the Iowa Model or Plan-Do-Study-Act (PDSA).

Implementation/Intervention

Describes the actual practice changes made or planned to address the problem.

References

Should be from the last 5-7 years.

List three learning objectives for your Presentation

Specify Employment / Affiliations

Funding Sources

Is there is a conflict of interest that needs to be disclosed?(Required)

Yes

Potential or actual conflict of interest exists when commitments and obligations are likely to be compromised by the nominator(s) other material interests, or relationships (especially economic), particularly if those interests or commitments are not disclosed. Indicate if the presenter(s) has an economic interest in, or acts as an officer or a director of, any outside entity whose financial interests would reasonably appear to be affected by the addition of the nominated condition to the newborn screening panel. The presenter(s) should also disclose any personal, business, or volunteer affiliations that may give rise to a real or apparent conflict of interest. Relevant Federally and organizationally established regulations and guidelines in financial conflicts must be abided by. Individuals with a conflict of interest should refrain from nominating a condition for screening.

Please specify other nonprofit and for-profit boards you (and your spouse) sit on, any for-profit businesses for which you or immediate family members are an officer or director, or a majority shareholder, and the name of your employer and any businesses you or a family member own.

I understand that oral presentations may be recorded and shared via NACN-USA.(Required)

I agree

I hereby certify that the information set forth above is true and complete to the best of my knowledge.(Required)

I confirm

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