th
NNUAL
ERINATAL
URSES
ONFERENCE
st
Crown Plaza – White Plains-Downtown – 66 Hale Avenue, White Plains, NY 10601
Please type. You may photocopy as necessary for additional authors.
Handwritten documents will not be accepted.
1. Name
Name and Degrees
2. Home
Address Number and Street
City, State, Zip Code
Telephone Number
3. Business
Address Employer Name/Department
Fax Number
City
Present Position Title & Description
Number and Street
State
Email Address
Zip Code
Telephone Number Fax Number Email Address
4. Submit your CV or resume
5. Complete the Biographical Data/Vested Interest form
6. Complete the Educational Activity Overview
7. Submit an abstract of your presentation, limit to 250 words. Your abstract will be reproduced and distributed to conference participants with their registration materials.
8. Complete and return before Friday, February 13 th , 2015 by 3:00pm to: (prefer Email.)
Madeline Britt, Statewide Program Coordinator
March of Dimes New York State Chapter
515 Madison Avenue, 20 th Floor
New York, NY 10022
E-mail: mbritt@marchofdimes.org
You will be notified by telephone in early March 2015

ABSTRACT
Type or print clearly. Please limit your abstract to 250 words. (click on the gray shaded box and start typing).
ALSO REQUIRED ARE THESES FILES
To be completed and return with completed proposals.
Biographical and Conflict of Interest Form
FOR YOUR INFORMATION
Objective and Content
Blooms Taxonomy Verbs Document
Writing using a narrative style
2