MMEA In-service workshop/conference

January 27-30, 2021
Tan-Tar-A Conference Center

2021 Clinic/session information form



2021 MMEA Clinic/Session Proposal Form

  • Contact Information

    Please enter contact information for the person proposing the clinic/session.
  • Clinic/Session Information

  • Enter the proposed Title for the clinic/session (if applicable).
  • Enter a description for the subject content of the clinic/session (If applicable).
  • Please include any additional information pertaining to the clinic/session being proposes (If applicable):
  • Clinician Information:

  • Please list affiliation & title with school/university/company, et.
  • Please list all potential sponsorship for the the clinic and/or clinician expenses.