CONFERENCE PROPOSAL FORM

         FALL 2010 Focus Topic:
        What IF - - -
        Other  

         Presentation Format (select one):

        75-minute breakout workshop
        Poster session (Please complete #1, 3 and 6 below)

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
   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) or Poster Session Contact:
1. 
   

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

   
   
   
2. Additional Presenters
   

   Name(s)
   Title(s)
   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
Initials:

Email your completed proposal to boedgin@cccaoe.org