2010 Annual NASW-AK/AkCA Conference Survey

1. 2010 NASW-AK/AkCA Annual Conference in FAIRBANKS

The 2010 National Association of Social Workers -- Alaska Chapter/Alaska Counseling Association Annual Conference will be held October 6, 7 and 8 at the Westmark Hotel in Fairbanks. The Theme will be “Pulling Together — Across Disciplines, Communities, and Cultures.” All proposals will be read and we will make every effort to include all qualified presenters. As compensation for presentations, Conference Registration will be waived. ALL PRESENTATIONS MUST BE RECEIVED BY JUNE 15TH.

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1. Please provide information on the presenter(s).

Please provide information on the presenter(s). Name:
Address:
City, State and Zip Code:
Email Address:
CELL Phone Number:

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2. What is the working title of your presentation? (This can be changed later if necessary.)

What is the working title of your presentation? (This can be changed later if necessary.)

3. Please indicate the type of presentation you are interested in providing:

Please indicate the type of presentation you are interested in providing: Breakout Session

Group Discission

Lecture

Dynamic Role Playing

Small Group Work

Video/Movie Presentation

Other (please specify)

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4. Please provide a brief abstract of your presentation including goals and objectives.

Please provide a brief abstract of your presentation including goals and objectives.

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5. Please provide a synopsis of your education, experience and interest in this topic. You may also provide a web link to a resume or other biographical data. Please be succinct because we will use this information for the program and publicity materials.

Please provide a synopsis of your education, experience and interest in this topic. You may also provide a web link to a resume or other biographical data. Please be succinct because we will use this information for the program and publicity materials.

6. To what level of education or experience is your presentation directed?

To what level of education or experience is your presentation directed? General Information

Mid-Level Experience

Higher-Level Experience

Other (please specify)

7. Please select your preferred presentation day and time of day:

Please select your preferred presentation day and time of day: Wednesday, October 6th, morning

Wednesday, October 6th, afternoon

Thursday, October 7th, morning

Thursday, October 7th, afternoon

Friday, October 8th, morning

Friday, October 8th, afternoon

No Preference

8. Which CEU area will your presentation address?

Which CEU area will your presentation address? Alaska-Native Specific

Cross-Cultural

Ethics

Substance Abuse

General CEU

9. How long will your presentation be?

How long will your presentation be? One Hour

Two Hours

Three Hours

All Day

10. Please indicate the equipment you will need for your presentation.

Please indicate the equipment you will need for your presentation. Laptop Computer

LCD Projector and Screen

TV with VCR

TV with DVD Player

Flip Chart and Markers

Clip-On Microphone

Other (please specify)

2010 Annual NASW-AK/AkCA ConferenceExit this survey

1. 2010 NASW-AK/AkCA Annual Conference in FAIRBANKS

*1. Please provide information on the presenter(s).

*2. What is the working title of your presentation? (This can be changed later if necessary.)

3. Please indicate the type of presentation you are interested in providing:

*4. Please provide a brief abstract of your presentation including goals and objectives.

*5. Please provide a synopsis of your education, experience and interest in this topic. You may also provide a web link to a resume or other biographical data. Please be succinct because we will use this information for the program and publicity materials.

6. To what level of education or experience is your presentation directed?

7. Please select your preferred presentation day and time of day:

8. Which CEU area will your presentation address?

9. How long will your presentation be?

10. Please indicate the equipment you will need for your presentation.

2010 Annual NASW-AK/AkCA Conference
Exit this survey

*
1. Please provide information on the presenter(s).

*
2. What is the working title of your presentation? (This can be changed later if necessary.)

*
4. Please provide a brief abstract of your presentation including goals and objectives.

*
5. Please provide a synopsis of your education, experience and interest in this topic. You may also provide a web link to a resume or other biographical data. Please be succinct because we will use this information for the program and publicity materials.