Presentation Worksheet

Please complete the following worksheet with the requested information and submit it by June 15, 2017.

Contact Name(s):

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* 1. Contact Name(s):

Contact Email(s):

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* 2. Contact Email(s):

Contact Phone Number(s):

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* 3. Contact Phone Number(s):

For which regional meeting would you like your proposal to be considered?

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* 4. For which regional meeting would you like your proposal to be considered?

Name of Presenter(s) (if different than above)

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* 5. Name of Presenter(s) (if different than above)

Presenter(s') Bio(s) (75 words or less)

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* 6. Presenter(s') Bio(s) (75 words or less)

Topic/Subject Area

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* 7. Topic/Subject Area

Session Title (This can be a working title)

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* 8. Session Title (This can be a working title)

Session Description (approximately 100 words)

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* 9. Session Description (approximately 100 words)

Format

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* 10. Format

What key takeaways will this session provide attendees?

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* 11. What key takeaways will this session provide attendees?

Comments

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* 12. Comments

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