PRESENTER INFORMATION
Please complete the following information exactly as it should appear in all conference materials including the final brochure and name badges.

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* 1. Presenter Information:

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* 2. Additional Presenters:

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* 3. Additional Presenters:

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* 4. Additional Presenters:

PRESENTATION INFORMATION
Please complete the following information exactly as it should appear in all conference materials including the final brochure. Description for conference brochure is limited to 500 characters.

Question Title

* 5. Title of Presentation

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* 6. Description of Presentation:

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* 7. Please indicate availability for presentation (check all that apply):

Continuing Education Credits for Social Workers, LMHC & CASAC:

If your session’s objectives are pertinent to social workers, please email the following information to nyscaremanagement@gmail.com upon submission of this form:

1. A biographical summary, resume, or CV for each presenter; and

2. Learning Objectives & Pre– and Post-Assessments: In an attempt to gauge how well participants grasp the knowledge they are exposed to in your session, please list three learning objectives and three pre– and post-assessment questions on a separate sheet of paper. Participants will respond to the same question items on the pre– and post-assessments. Each objective should begin with “After completing this session, participants will…” and question types should be either True / False or Multiple Choice (3-4 choices). Please highlight correct answers.

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