Please enable JavaScript in your browser to complete this form.SACRPH 2022 ROUNDTABLE and WORKSHOP SUBMISSION FORMDIRECTIONSPlease use this form to submit a roundtable or workshop proposal to the SACRPH 2022 Program Committee. At the bottom of the form, please upload a SINGLE PDF or Word file with the following: 1) Cover page with roundtable/workshop title and list of participants; 2) Overview of the session’s themes, significance, and format, in 100 words or less; 3) Discussion of potential contributions of participants (if not in Overview); 4) One-page CV for each participant. For the filename, please use this nomenclature: “Format, Short Title”. Roundtable or Workshop Session Title *Please propose a succinct title for your program.Is this roundtable or workshop available virtually October 20 or in-person on October 22, or EITHER? *ONLY virtually, Thursday, October 20ONLY in-person, Saturday, October 22EITHER virtually (October 20) OR in-person (October 22)Keywords for Roundtable or Workshop *Please provide four keywords identifying the thematic emphases of the topic.How many people will participate in this roundtable or workshop, NOT including the Chair? *One personTwo peopleThree peopleFour peopleFive peopleCHAIR and LEAD CONTACTRoundtable or Workshop Chair and Lead Contact: Name *FirstMiddleLastChair and Lead Contact: Institution or Professional Organization *Chair and Lead Contact: Email * Chair and Lead Contact: Time Zone for Virtual Presentation *EasternCentralMountainPacificAsian time zonesEuropean time zonesOther time zonesIn what time zone would this person potentially be presenting from? Mobile Phone Number *PARTICIPANT 1Participant 1: Name *FirstMiddleLastParticipant 1: Institution or Professional Organization *Participant 1: Email *Participant 1: Time Zone for Virtual Presentation *EasternCentralMountainPacificAsian time zonesEuropean time zonesOther time zonesIn what time zone would this person potentially be presenting from? PARTICIPANT 2Participant 2: Name *FirstMiddleLastParticipant 2: Institution or Professional Organization *Participant 2: Email *Participant 2: Time Zone for Virtual Presentation *EasternCentralMountainPacificAsian time zonesEuropean time zonesOther time zonesIn what time zone would this person potentially be presenting from? PARTICIPANT 3Participant 3: Name *FirstMiddleLastParticipant 3: Institution or Professional Organization *Participant 3: Email *Participant 3: Time Zone for Virtual Presentation *EasternCentralMountainPacificAsian time zonesEuropean time zonesOther time zonesIn what time zone would this person potentially be presenting from? PARTICIPANT 4Participant 4: Name *FirstMiddleLastParticipant 4: Institution or Professional Organization *Participant 4: Email *Participant 4: Time Zone for Virtual Presentation *EasternCentralMountainPacificAsian time zonesEuropean time zonesOther time zonesIn what time zone would this person potentially be presenting from? PARTICIPANT 5Participant 5: Name *FirstMiddleLastParticipant 5: Institution or Professional Organization *Participant 5: Email *Participant 5: Time Zone for Virtual Presentation *EasternCentralMountainPacificAsian time zonesEuropean time zonesOther time zonesIn what time zone would this person potentially be presenting from? FINAL NOTES AND UPLOADAdditional Notes for SACRPH 2022 Program Committee (Optional)Upload a SINGLE PDF or Word file, per directions below. * Click or drag a file to this area to upload. Please upload a SINGLE PDF or Word file with the following: 1) Cover page with roundtable/workshop title and list of participants; 2) Overview of the session’s themes, significance, and format, in 100 words or less; 3) Discussion of potential contributions of participants (if not in Overview); 4) One-page CV for each participant. For the filename, please use this nomenclature: “Format, Short Title”. NameSubmit