below concerning a presentation you made either as a stand-alone offering
or when you served as a main presenter at an invited event.
typical example would be a "Medical Overview" talk for the Alzheimer's
Association - other Association staff may speak before or after you, but
your talk is the main presentation on the disease process. Please do
not enter presentations from conferences or university courses on this
form. There are separate icons for these on the database
Please fill in the requested information below.
Most important fields are in RED.
Leave blank those fields
that do not apply or for which information is not available. SUBMIT button
Last Name of Presenter:
Date of Presentation:
Title of Presentation:
Location of Presentation:
(City, State and/or Country)
(e.g., Alzheimer's Association)
(e.g., St. Louis Area Agency on Aging)
Knight ADRC Tuesday Noon Seminar
Minority Outreach / Recruitment Event
Event for a LAY or Caregiver Audience
Event for a PROFESSIONAL Audience
Event Specifically for RURAL Lay Audience
Event for Specifically for a RURAL Professional Audience
Hands on Neuroscience Presentation for Children
Other Presentation at WUSM
Other (Explain in Comments)
Duration of Presentation (in hours):
(e.g., 2.5 equals two and a half hours)
Approximate Number in Attendance:
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estimate the % of individuals present
from the following
(% of total audience)
Lay / Caregiver
(Together must add to 100%)
Other Health Profession
add to 100%)
Child - High
Child - Middle
Child - Elementary School
Did this event meet its educational
and/or outreach goals?
Were evaluation forms distributed?
If Yes, what was the average overall
(e.g., 4.23 on a 1-5 Scale; 5 = Excellent)
If applicable, please describe the funding/cost breakdown
for this event in the box below.
(e.g., $5,000 Novartis Grant, $2,000 contributed by Knight ADRC)
You are limited to 255 characters
for each of these comment boxes. Use abbreviations when you can. If you
have more to say than will fit, please e-mail this information to Tom
Meuser, Education Director.