APTA Michigan Conference Course Submission Form
Please be aware that course proposals for Fall Conference are due for consideration by April 1, 2025. Please note that speaker honorariums are given for each session, not each speaker. For a detailed list of our speaker policy please email edward@aptami.org
Lead Presenter Name
*
First Name
Last Name
Degree/ Credentials
Lead Presenter Email
*
example@example.com
Leader Presenter Phone Number
*
Please enter a valid phone number.
I am traveling from outside of Michigan
Please Select
Yes
No
Co-Speaker name and email (if applicable)
Co-Speaker name and email (if applicable)
Co-Speaker name and email (if applicable)
Co-Speaker name and email (if applicable)
Preferred Conference
*
2025 Fall Conference, Oct 17-18, 2025 TreeTops Resort, Gaylord
2026 Fall Conference, TBA
Course Title
*
Brief Course Description: Please include how/why course content is directly related to physical therapy and how content improves a participant’s knowledge or skills in physical therapy.
*
0/250
Preferred Length of Session
*
Please Select
1 hour
2 hours
3 hours
Speaker(s) Bio
*
Previous Speaking Experience
*
Facility
District
SIG
State Conference
CSM
Section/Academy Conference
Other National Conference
Other
Teaching Method
*
Lecture
Lab
Discussion
Panel
Other
List at least 3 Course/Learning Objectives?
*
Program or Course bibliography of at least 5 published works, published within the last 7-10 years supporting the content of the course
*
Conflict of Interest Disclosures
*
No conflict of interest to declare
List conflict of interest in next box
Conflicts of Interest:
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