CONFERENCE PROPOSAL FORM

        Spring 2012 Focus Topic (each with a business/ industry partner):
        Please select one per submission

        Title IIB Leadership
        Workforce & Economic Development
        CTE Collaboratives
       

         Presentation Format: 60-minute breakout workshop 

1. Presentation Title (10 words or less)



2. Presentation description (50 words or less)



3. Abstract (one paragraph including the following)
   1. Top three points that participants will gain from your presentation
   2. Interaction with your audience (small group discussion, role play, Q&A – be creative, be fun)
   3. Methods and materials you will use (overheads, PowerPoint, icebreakers, hand-outs)




4. Equipment/Technology
1. Provided at no cost, check if requesting:       
   Screen
   Flip chart
2. PowerPoint Presentation
   
   

   CCCAOE does not provide computers or LCD projectors. Equipment you will be bringing

    Data/video (LCD) projector
     Computer
      Other (please describe)
   
   
   
   
3. There will be a charge to provide Internet access/telephone line/VCR, monitor
   Equipment you are requesting at your individual/added cost:
    Internet
    Telephone conference call line
      Other (please describe):
   
   



5. Speaker qualifications and background (one paragraph maximum)



6. Speaker/s (maximum of four speaker/presenters)
   
   
1. Lead Contact Person
   * are required
   

   *Contact Person
   *Name(s)
   *Title(s)
   *College or Organization
   *Work address
   *city
   *state
   *zip
   *Day Phone
   Evening Phone
   *Email

   
   
   
• Additional 1
• Additional 2
• Additional 3


First Additional Presenter
Name
Title
College or Organization
Work address
city
state
zip
Day phone
Evening phone
Email


Second Additional Presenter
Name
Title
College or Organization
Work address
city
state
zip
Day phone
Evening phone
Email


Third Additional Presenter
Name
Title
College or Organization
Work address
city
state
zip
Day phone
Evening phone
Email



7. Day and/or Time Constraints (every effort will be made to accommodate your request)



8. Expenses and Signature:  

The Contact Person above agrees to the guidelines for submitting proposals and to inform all presenters that they are required to register and pay the conference registration fee and that neither honoraria nor expenses will be paid to program presenters. Presenters will be charged for items listed in section 4c if requested. Presenters who attend for one day are eligible for a special conference rate.

 Check here to agree

Questions:  Contact Sid Burks, President Elect/Conference Chair
 at sidney.burks@chaffey.edu or 909-652-6840