Presiding Chair Form (Doctor)

We rely on our members to serve as Presiding Chairs

For the 2024 Midwinter Meeting, we need Presiding Chairs for the following dates:

Thursday, Feb. 22
Friday, Feb. 23
Saturday, Feb. 24

As a Presiding Chair, you will receive CE credit, breakfast, lunch and a $100 honorarium for serving throughout the day to assist in the course room and introducing speakers. Thank you for your service.

Complete the application below.

CDS Member Number

Prefix

Dr.

Mr.

Ms.

First Name

Last Name

Address 1

Address 2

City

State

Zip

Phone Number

Email Address

Are you interested in serving for more than one day?

Yes

Days I wish to serve

Thursday, Feb. 22, 2024

Friday, Feb. 23, 2024

Saturday, Feb. 24, 2024

I agree to provide a personal signature in order to allow CDS to process my per diem check

I agree