2020 NAIIS Poster Abstract Submission

Lead Author

Lead Author Name:*

Credentials:

Organization:*

(Please spell out, i.e., no acronyms)

Organization Type:*

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If Other, please specify:

Address:*

Address 2:

City, State, Zip:*

Telephone:*

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Email Address:*

Are there Co-Authors?*

Co-Author(s)*

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Name:	Organization:	Email:

Co-author approval:*

Check this box to confirm that the co-author(s) has/have approved this submission.

Does the author or any co-author have any conflicts of interest?*

(If you are unsure about the answer to this question, please contact LaDora Woods at ecz3@cdc.gov for additional information.)

If yes, please identify the author(s) and conflict(s):

Abstract Title:*

Main topics included in abstract:*

(select all that apply)

If other, please describe

Abstract:

(150 words or less)

Upload Abstract:

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If accepted, do you agree to have your poster and abstract posted to the Summit’s website after the meeting?*