Abstract submission form

Submissions must be received by Monday, January 26, 2004. Presenters will be notified of acceptance by February 3, 2003.

Abstracts should demonstrate that your topic is timely and relevant to minority health and the conference theme, and meet the following guidelines:

Abstracts must be typed, single-spaced, and no more than 250 words.
Center title at top of page followed by author�s name and academic degrees.
Organize by sub-headings: Introduction, Methods, Results, and Conclusion.
Include the presenting author�s position/title, mailing address, phone number (including area code), fax number and e-mail address.

Directions: Compose your abstract in a word processing program, saving regularly. When finished, complete the items below and then copy and paste the text of the abstract into the box. Or print this form and complete using a typewriter and mail to 26th Annual Minority Health Conference Poster Presentations, c/o Yolanda Riggsbee, Office of Continuing Education, School of Public Health, Campus Box 8165, Chapel Hill, NC 27599-8165 .

Required fields are marked with an "*"

1. Name*:
	First*	Middle	Last*

2. If you are a Student:
3. If you are a Faculty Member:
4. Organization type:

5. Organization Name*:
6. Position/Title*:
7. E-mail address*:
8. Telephone*:
9. Fax*:

10. Address 1st line*
11. Address 2nd line

12. City, State*
	City*	State*	Postal code*

13. How many UNC School of Public Health Minority Health Conferences have you attended, if any?
14. Would you like to receive announcements (maximum 12/year) about minority health / public health events?		Yes No

15. Abstract title*

16. Abstract text*

All abstracts accepted for presentation, unless withdrawn, will be posted on the Conference website, along with the presenter's name, position, and affiliation.

26th Annual Minority Health Conference