Host Team & Speaker Registration

JHU Healthcare Ledership Collaborative; Acceleration Wellbeing Solutions & Transforming workforce Culture; In partnership with all in: Wellbeing First for Healthcare, a coalition led by the Dr. Lorna Breen Heroes" foundation

Name(Required)

Designatory Letters

Email(Required)

Organization(Required)

Position Title(Required)

Accessibility Needs

Dietary Restrictions

Would you be willing to serve as a volunteer the day of the event if need?

If so, we will be in touch as we get closer to the event.

Yes, for the majority of the event

Yes, for part of the event

No, I am unavailable and/or have preexisting commitments

N/A - I am not a part of the host team (ex. speaker, panelist, etc.)

Will you be joining us for the 4:30 - 5:30 PM reception?*(Required)

Yes

Consent Form(Required)

I consent to sharing my contact information (name, email, organization, and title). I consent to being photographed during the event and allow event organizers to use these photos for promotional and informational purposes.

Comments

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Host Team & Speaker Registration

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