PBPLS Workshop Proposal Form

Thank you for your interest in presenting a workshop at this years Portland Black Pride LGBTQ Summit. Each workshop will be awarded a $50 honorarium.

A huge thank you to this years sponsors (so far):
PFLAG Portland/PFLAG Black Chapter, Cascade AIDS Project
Basic Rights Oregon,Multnomah Cournty HIV/AIDS Prevention Program,Crossover

* 1. Title of workshop (as it should be printed in brochure):

* 2. Presenter contact information:

* 3. Additional presenter contact information (leave blank if only one presenter):

* 4. Please provide a detailed description of the workshop or presentation
you are interested in giving (200 words minimum):

* 5. What is the duration of your workshop?

* 6. It is our desire for presenters to be a part of the round table discussion during lunch will you be available?

* 7. Do you have prior experience giving this workshop?

* 8. Who is the intended audience for your presentation?

* 9. Is the material in your presentation appropriate for all ages?

* 10. Please indicate any materials or equipment needed - be specific (whiteboard, dvd player, internet access, etc.).

* 11. Would you be interested in presenting with others?

* 12. Brief bio of presenter(s):