MACAA appreciates your interest in facilitating a workshop at the 2021 Annual Conference.  Please read and complete this form in its entirety and submit all information by Monday, November 22nd.  Thank you for your interest in working with MACAA as we strive to provide world class training and technical assistance to our network of agencies.  Please contact Nicole Claiborne, Executive Director, at 601.882.5980 for additional information.

Question Title

* CONTACT INFORMATION

Question Title

* Would you like to be a 

Question Title

* Title of your presentation

Question Title

* Workshop Abstract (50 words or less)

Question Title

* List at least three learning objectives:

Question Title

* Will your presentation be 

Question Title

* Brief Bio: (120 words max)

Question Title

* Brief Bio (Co-presenters):

Question Title

* Presenter(s) Photos: Please email an electronic copy of presenter's and co-presenter's head shot to nclaiborne@msacaa.com by November 23rd.

Question Title

* Presentation Cost

Question Title

* If you answered fees, please list the amount per session

T