Annual Meeting – Shark Tank and Residents/Medical Students Registration 2016 Ohio AAP Annual Meeting #OhioAAPAM Please compete the form below to register for the Shark Tank Poster Presentation Competition at the Ohio AAP Annual Meeting. Name * First Last Name * Last, Credentials Email Address * Address * Street City * State * Ohio Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code * Phone * What would you like to register for? * Shark Tank Only Shark Tank & Annual Meeting Educational Sessions Only Annual Meeting Educational Sessions Shark Tank Registration Please sign me up for the following: * Shark Tank - Research Posters (Friday, Sept. 23 - 1:45-3:45pm) Shark Tank - Program Posters (Friday, Sept. 23 - 1:45-3:45pm) Project/Poster Title: * In the space provided below, please provide poster/program description that includes an overview of implementation and any outcomes of this effort (please limit your response to 300 words). * Annual Meeting Educational Sessions Please select your preferred track for Friday from 1:45 to 3:45 PM * Shark Tank MOC Part II Track CME Track N/A - I don't plan to attend this portion. Please select your preferred session for Friday from 4:00 to 5:00 PM * MOC Part II - Bullying MOC Part II - Resiliency CME Track N/A - I don't plan to attend this portion. Would you like to attend the 2016 Ohio AAP Awards Reception and/or the 2016 Casino Night Fundraiser (Tickets Required - $60/Each or $100/Couple)? * Awards Reception Only Casino Night Only Awards Reception & Casino Night N/A - I don't plan to attend either of these. Please select your preferred session for Saturday from 9:30 to 10:30 AM MOC Part II - Injury Prevention - Birth to 4 MOC Part II - Resiliency CME Track N/A - I don't plan to attend this portion.