Wyoming Society for Respiratory Care - Conference Speaker Information

Thank you for your interest in joining us as a speaker and for being a part of our WySRC Fall Conference. Please submit the following form for consideration for our next conference. The deadline for your information is August 1, 2025. This year’s Fall Conference is September 18 & 19, 2025, at the Hilton Garden Inn in Casper, WY.

To present on multiple topics, complete a second form with the additional topics.

We look forward to having you at our conference this year.

Step 1 of 2 – Speaker Information

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone(Required)

Email(Required)

Title and Place of Employment(Required)

Highlights of your Career

Proposed Topic(Required)

Please list three measurable learner outcomes(Required)

Please list one outcome per line. Use the plus sign on the side to add another line. 3 Objectives are required for CRCE’s

Availability (Please check all dates available)

Day 1 – Morning (8am-10:30am)

Day 1 – Afternoon (1pm-4:30pm)

Day 2 – Morning (8am-12:30pm)

Availability Continued…

If you have a specific date/time requirement, please provide it here

Do you have a sponsor?

This is if a company or individual will covering expenses associated with speaking at the conference.

Yes

Sponsor's Name(Required)

First Last

Sponsor's Email(Required)

What accommodations do you need the WySRC to provide?

Please list. (ie: fuel, hotel, flight, etc)

Please provide an introduction to be read prior to your presentation.

Headshot Upload

We’re excited to feature YOU! To participate, simply upload your best professional headshot or photo and get ready to shine. We will spotlight you as a speaker at the conference!

Max. file size: 512 MB.

Comments

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