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Submit a Presentation/Publication

Please submit each publication or presentation separately, only one to a form, for possible use in print or electronic publications. To submit an Honor, Award or Certification see this form.

* Indicates required field.

Presentation/Publication Information

*Date of Presentation: xx/xx/xxxx

*Title of Presentation/ Publication:

*Presentation/Publication Type:

Poster

Panel

Lecture

Book

Chapter in Book

Journal Article

Other

*Where presented (conference, meeting)/published:

*Sponsoring organization, conference, meeting title:

Location

*City:

*State:

*Country:

Other Significant Information:

Presenter's/Author's Information

*Name:

*Doctoral Degree
(if applicable):

*School/Unit:

Academic Affairs

Central Administration

Dental Branch

Graduate School of Biomedical Sciences

Harris County Psychiatric Center

Institute of Molecular Medicine

Medical School

Mental Sciences Institute

School of Health Information Sciences

School of Nursing

School of Public Health

Department:

*Status:

Faculty

Post Doctorate

Resident

Staff

Student

*Title:

*E-mail:

Phone No.:

Alternate Phone No.:

Submitted by (if different from presenter/author):

*Name:

*E-mail:

Phone No.:

*Validate Image: