* 1. Name(s) of Speaker(s) (as it will appear in the conference program):

* 2. Title of Presentation (as you want it to appear in the conference program):

* 3. Who is your target audience for the program? (Adult Services, Children’s Services, Support Staff, General, etc):

* 4. Description of Presentation (as you want it to appear in the conference program; no more than 100 words). Keep it short and simple – this is what will draw the crowd!

* 5. Programs must be sponsored by a CLA member, section, or committee. Sponsorship involves all planning, communication, and arrangements. A CLA member may sponsor him/herself as a presenter. Please list the name of the CLA section, CLA committee, or CLA member sponsoring the program, and any co-sponsors:

* 6. If you are submitting more than one program, what priority are you assigning this program? Note: Please provide a separate program proposal form for each program.

Low Priority
i We adjusted the number you entered based on the slider’s scale.

* 7. Which day / time of day do you prefer? Note: flexibility regarding day and time of program is highly preferred.

* 8. This year we are offering an option of 50 minutes or 2 hour timeframes, please indicate which timeframe you wish to fill.

* 9. Each program room can be equipped with projector/screen setup, and wifi. Presenters will be responsible for providing their own laptops and cables. What are your speaker’s additional A/V needs?

* 10. If your speaker or speakers have a book or books available for purchase at the conference, please list them here:

* 11. What is your estimated budget (fees and reimbursement) for this program?

* 12. Does your speaker/presenter require special accommodations? Please describe them.

* 13. Additional comments?

* 14. Lead Planner Information: