NCFADS Speaker Information and Topic Proposal

Presenter Contact Information

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* 1. Contact Information

Name *

Company

Address *

Address 2 *

City/Town *

State/Province *

ZIP/Postal Code *

Country *

Email Address *

Phone Number *

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* 2. Listing of Your Nominal Letters (including full title of each). One Per Line.
Example: "LCAS - Licensed Clinical Addictions Specialist"

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* 3. Please Provide a ONE Paragraph Biography (100 Words or Less).

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* 4. Noteworthy Awards, Recognition, Accomplishments, or Completed Projects/Research?

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* 5. Have You Presented At An NCFADS Summer and/or Winter School Before?

Yes

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* 6. Please Indicate the School(s) You Would Like to Present At

Winter School (Typically in February in Greensboro, NC)

Summer School (Typically in late July in Wilmington, NC)

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* 7. If a virtual option was available, are you interested in presenting an NCFADS session in a virtual platform?

Yes, I have experience and love presenting virtually.

Yes, I am comfortable presenting virtually.

Yes. I have not presented virtually in the past but I am interested in the opportunity and willing to try.

No, I do not wish to present in a virtual platform. My session is best taught in an in-person environment.

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* 8. Please Indicate the TYPE of Proposed Presentation

Mini-Track (3-3.5 Hours)

Main Track (11-15 Hours - Across 3 Training Days)

Plenary (1-2 Hours)

Evening Session (2 Hours)

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* 9. Presentation Title (10 Words or Less)

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* 10. Description of Presentation (150 Words or Less)

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* 11. Presentation Objectives
(List at least one measurable objective for each hour of the presentation)

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* 12. Technology + Multimedia Requirements

Projector

Audio Speakers

Flip Chart + Markers

Loaner Laptop (using your own laptop is suggested for file compatibility)

Laser Pointer / Presentation Clicker

Microphone

DVD/Blu-Ray Player

Other (please specify)

Question Title

* 1. Contact Information

Question Title

* 2. Listing of Your Nominal Letters (including full title of each). One Per Line. Example: "LCAS - Licensed Clinical Addictions Specialist"

Question Title

* 3. Please Provide a ONE Paragraph Biography (100 Words or Less).

Question Title

* 4. Noteworthy Awards, Recognition, Accomplishments, or Completed Projects/Research?

Question Title

* 5. Have You Presented At An NCFADS Summer and/or Winter School Before?

Question Title

* 6. Please Indicate the School(s) You Would Like to Present At

Question Title

* 7. If a virtual option was available, are you interested in presenting an NCFADS session in a virtual platform?

Question Title

* 8. Please Indicate the TYPE of Proposed Presentation

Question Title

* 9. Presentation Title (10 Words or Less)

Question Title

* 10. Description of Presentation (150 Words or Less)

Question Title

* 11. Presentation Objectives (List at least one measurable objective for each hour of the presentation)

Question Title

* 12. Technology + Multimedia Requirements

Question Title

* 13. OPTIONAL: How and Why Will Your Presentation Be Relevant, Noteworthy, and Memorable?

* 2. Listing of Your Nominal Letters (including full title of each). One Per Line.
Example: "LCAS - Licensed Clinical Addictions Specialist"

* 11. Presentation Objectives
(List at least one measurable objective for each hour of the presentation)

* 13. OPTIONAL:
How and Why Will Your Presentation Be Relevant, Noteworthy, and Memorable?