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SOUTHEASTERN ATLANTIC REGION
Southeastern Atlantic Region
Exhibitor Award
Name of Institution*
NNLM Member ID*
Project Manager*
Position/Title of Project Manager*
Department of Project Manager*
Mailing Address*
Street 1
Street 2
City
State
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip Code
Email Address*
Telephone Number*
Award should be made payable to what institution (e.g. Southeastern Regional Medical Center)*
Federal Tax ID Number (FEIN)*
DUNS number* (9-digit number)
Congressional District*
Proposed start date of project*
Direct Beneficiaries
Check all that apply:*
Consumers
General Public
Patients & Families
Scientists
Biomed/Genetics/Biotech
Chemistry/Toxicology/Environment
Librarians
Health Science
Hospital
Public/Other
Students
College
Health Professionals
K-12
Health Professionals
All Types (no special focus)
Allied Health
Dentists
Health Intermediaries
Health Services Researchers
Mental Health
Nurses
Pharmacists
Physicians
Public Health Work Force
Veterinarians
Other
Other
Disaster & Emergency Professionals/Responders
Educators
Health Administrators
Historians
Journalists
Other
Primary Populations Served by project
select up to three primary populations*
Not Applicable
African Americans
Alaska Natives
American Indians
Asian Americans
Displaced
Hispanics/Latinos
HIV/AIDS
Inner City
International
Native Hawaiians
Pacific Islanders
Rural
Seniors
Women
Youth/Teens
Other
Project Goals
Please check the goals that apply*
Goal ID
Applies
Description
1.
Increase awareness use of NLM information resources.
2.
Serve as a primary source for reliable and authenticated content.
3.
Train in the use of medical information resources.
4.
Strengthen communications and connectivity for health, i.e. infrastructure.
5.
Conduct and support basic and applied research to identify the need for, access to, evaluation of, and use of health information resources and systems.
6.
Reduce and eliminate health disparities among minority and other underserved populations. Support the information needs of health professionals who serve underserved and special populations.
7.
Partner with organizations to increase awareness and use of freely available authoritative health information.
8.
Upgrade, replace or adopt technologies that will increase access to health information.
9.
Facilitate the acquisition of mobile technologies to assist health professionals in providing services at point of need.
10.
Assess the information needs of populations and communities to enhance the development of relevant community programming.
11.
Analyze the information seeking practices and educational needs of practitioners to shape programming.
12.
Promote the role of hospital libraries in the patient care process.
13.
Provide librarians with the tools and skills needed to develop advocacy programming.
14.
Reduce health disparities minority, displaced, rural and other underserved populations. Support the information needs of health professionals who serve underserved and special populations.
Name of meeting or sponsoring organization; date and location of exhibit.* [200 characters]
Expected audience (e.g., "Public health professionals in Florida. Average annual meeting attendance is 400.") and information need.* [4000 characters]
Describe physical exhibit, handouts, and any special focus or theme; include a description of NLM products that will be featured and other planned promotions.* [4000 characters]
List of personnel and experience relevant to this project, including qualifications to present NLM products.* [4000 characters]
Other participation in this meeting? Will you give a talk, teach a workshop, or network in some other way?* [4000 characters]
How will you evaluate the success of your exhibit? [4000 characters]
Award funding is a maximum of $2,000. Please provide a brief budget.
Funding will cover registration and booth fees, travel and per diems, communication costs, and equipment rental if needed. Provide an explanation for other costs needed not listed above.
Meal per diems are the only allowable food expenditure.
Furniture costs (other than for booth rental) are not allowed.
No costs for promotional items are allowed.
Expenditure Category
Description
Total Charges
Booth Space
Other Booth Costs (furniture rental or carpeting)
Travel Costs (mileage & parking)
Other travel costs (lodging & per diem)
Internet Connection
Shipping
Materials
Additional (Please describe)
total amount requested ($2,000 maximum):
Provide a cost break down and justification for each budget line. [4000 characters]