2018 REACH(c) Whole School Reform Presentation Form

General Information

Please provide REACH(c) with all of the general information requested below, so that we are able to contact you.

Question Title

* 1. Answer all questions below.

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address (please provide the email address that you regularly address)

Work Number

Question Title

* 2. What is your current position?

Question Title

* 3. Ensure you are available to present during the following days and time?

Sunday, February 19, 2018 9:00 am - 4:00 pm

Monday, February 20, 2018 9:00 am - 4:00 pm

Tuesday, February 21, 2018 9:00 am - Noon

Question Title

* 4. Presentation Title

Question Title

* 5. Intended audience for presentation

Question Title

* 6. Session description

Question Title

* 7. How will you ensure that your presentation is interactive?

Strategy 1

Strategy 2

Strategy 3

Question Title

* 8. What is the impact of your coaching model?

Question Title

* 9. What is the artifact (evidence) of the positive impact of your coaching model?

Question Title

* 10. Provide the names of co-facilitators. Presentations may have up to four presenters.

Co-Presenter 1

Co-Presenter 2

Co-Presenter 3

Question Title

* 11. Presenters at REACH(c) conferences or related programs are expected to use material and language that do not discriminate on the basis of gender, race, color, ethnicity, religion, physical ability, or sexual orientation. Presenters must either own the content they are planning to present or have permission from its owner to deliver it at REACH(c) Whole School Reform: Coaching Through Systems that Work Conference.