2025 CALL FOR PRESENTATION FORM Please fill out this form if you would be interested in presenting for CHCA in 2025. Is this proposed education for:(Required) Assisted Living Conference - April 4, 2025-Building Financial Longevity and Viability Spring - May 20-22, 2025-Financial Management, Quality Outcomes, Administrator and DON Retention Fall - September 16-18, 2025-Innovation in Customer Service, Personnel Management, Leadership Skills, AL Financial Longevity and Viability Other CHCA Education-Social Services, Substance Use Disorder, Medicaid Pending Management, Discharge Planning Mini - Educational Session Speaker Name(Required)Speaker Company(Required)Best Contact Email for Speaker(Required)Best Phone Number for Speaker (including extension if applicable)(Required)Speaker Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country For Confirmation LettersSpeaker Timezone(Required)Presentation Title(Required)Presentation Duration(Required)How long will your presentation be?Proposed Presentation Date(Required)Would you like your presentation to be held virtually or in person?(Required) In Person Virtually Hybrid My presentation will be geared toward:(Required) Skilled Nursing Assisted Living Both Program Level(Required) Basic Intermediate Advanced Synopsis of Presentation(Required)In 150 words or less, provide a summary of the seminar's content. The summary must include a concise description of content which explains the value of the information and identifies new or unique application, and a description of the learning techniques that will be used to encourage discussion, participation and learning. What will be your specific target audience?(Required)Expected HonorariumFor over a quarter of a century, Colorado Health Care Association has earned it's reputation for providing high quality educational programs. We select faculty/speakers who share their expertise for the overall benefit of the long-term care profession. Therefore, CHCA rarely pays per diem, honoraria, or expenses. The Convention speakers budget is limited and only some keynote speakers and some selected, highly sought-after, expert speakers may be paid for their presentation. If you require or expect an honoraria or reimbursement for any of your expenses, you must indicate that on your application. Is the Honorarium Negotiable? Yes No Program MaterialMax. file size: 21 MB.Please upload any program material that will be used during the presentation. Please submit a biography for the speaker(Required) Δ