Presentation Proposal Request Survey

SHARE YOUR KNOWLEDGE WITH YOUR SOCIAL WORK COLLEAGUES AND BECOME PART OF NASW, TENNESSEE CHAPTER’S RESPECTED TEAM OF PRESENTERS

The Tennessee Chapter of NASW has established a reputation of providing quality training events for social work professionals in Tennessee. We are continually seeking qualified presenters who can address critical topics for social work professionals. We invite you to submit the below application to be considered for participation in our respected training team. Trainers selected for presentations of 3 or more hours receive honorariums and compensation for travel expenses with the Chapter office coordinating all event logistics.

1. Presenter Name and Degree

Presenter Name and Degree

2. Organization and Position Title

Organization and Position Title

3. Mailing Address (Include City, State and Zip code)

Mailing Address (Include City, State and Zip code)

4. Daytime Phone Number

Daytime Phone Number

5. Mobile Phone (if applicable)

Mobile Phone (if applicable)

6. Fax Number

Fax Number

7. E-Mail Address

E-Mail Address

8. Are you a member of NASW? (if so, include your member number)

Are you a member of NASW? (if so, include your member number)

9. Please provide a brief bio of 100 words or less. If you are selected as a presenter this would be included in the program announcement. Bio should include employment information and expertise in area of presentation; may also include service on social work boards and associations, schools attended and dates of degrees, and honors received. In addition to the bio statement, please email a copy of your resume or vita to Melissa West at NASW, Tennessee Chapter. Her email is mwest@naswtn.com.

Please provide a brief bio of 100 words or less. If you are selected as a presenter this would be included in the program announcement. Bio should include employment information and expertise in area of presentation; may also include service on social work boards and associations, schools attended and dates of degrees, and honors received. In addition to the bio statement, please email a copy of your resume or vita to Melissa West at NASW, Tennessee Chapter. Her email is mwest@naswtn.com.

10. Presentation Title

Presentation Title

11. Provide an overview/description of 100 words or less (in third person) of the topic on which you would like to present:

Provide an overview/description of 100 words or less (in third person) of the topic on which you would like to present:

12. Identify at least 3 specific learning objectives of the workshop:

Identify at least 3 specific learning objectives of the workshop:

13. Training Agenda:
Please include description of workshop agenda including details of presentation content and breaks. 1.0 CEU is granted for each 55 minutes spent in training. Credit is provided for time actually spent in training; break times do not count.

Training Agenda: Please include description of workshop agenda including details of presentation content and breaks. 1.0 CEU is granted for each 55 minutes spent in training. Credit is provided for time actually spent in training; break times do not count.

14. A/V Equipment Needed for Presentation:

A/V Equipment Needed for Presentation: PowerPoint Projector

Laptop

Screen

Writing Board/Flip Chart

TV/VCR

Lapel Mic

Other (please specify)

15. Time Required for Workshop:

Time Required for Workshop: 1 hour

1.5 hours

3 hours

6 hours

Multi-Day

Other (please specify)

16. Would you repeat this workshop if requested?

Would you repeat this workshop if requested? Yes

17. Have you presented this workshop previously?

Have you presented this workshop previously? Yes

18. How many times have you presented this workshop in the past?

How many times have you presented this workshop in the past?

19. Where have you presented this workshop in the past? Please include the date, conference name or organization, and the city.

Where have you presented this workshop in the past? Please include the date, conference name or organization, and the city.

20. Please provide three references from other workshops or training events you have conducted. (Include Name, E-mail address and Phone Number)

Please provide three references from other workshops or training events you have conducted. (Include Name, E-mail address and Phone Number) 1.
2.
3.

21. In which regions are you willing to present?

In which regions are you willing to present? Memphis

Jackson

Martin

Nashville

Knoxville

Johnson City

Chattanooga

Thank you for your willingness to share your expertise with your colleagues. The NASW-TN Continuing Education Committee will review applications and will recommend which workshops we schedule.

Please remember to email a copy of your resume or vita to Melissa West at mwest@naswtn.com. Please also contact Melissa if you have any questions at this email address or call the NASW-TN Chapter Office (877) 810-8103.

Presentation Proposal Request