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PRESENTER'S FIRST NAME
Please enter your first name as you would like it to appear in the Conference Program (information about co-presenters can be added toward the end of this form): *
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PRESENTER'S MIDDLE NAME OR INITIAL
Please enter your middle name or initial as you would like it to appear in the Conference Program:
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PRESENTER'S LAST NAME
Please enter your last name as you would like it to appear in the Conference Program: *
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INSTITUTION OR COMPANY NAME
Please enter the name of the presenter's school, institution or company as it should appear in the Conference Program: *
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Does this presenter represent a publisher, exhibitor or other entity that may offer items for sale related to the presentation?*
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If yes, will your company also be an exhibitor at this SWCOLT Annual Meeting? (For your convenience, we would like to coordinate all exhibitor sessions with the hours of the exhibit hall).
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MAILING ADDRESS
Please enter the presenter's street address: *
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City: *
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STATE: *
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ZIP Code: *
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E-MAIL ADDRESS
Please enter the presenter's preferred email address: *
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SECONDARY E-MAIL ADDRESS
If desired, please enter a second email address to be used if the first proves unsuccessful:
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PHONE NUMBER
Please enter the presenter's preferred phone number with AREA CODE (you may indicate a second number if desired): *
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SECONDARY PHONE NUMBER
If desired, please enter a second phone number with AREA CODE:
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PRESENTATION TYPE:
Breakout sessions of 60 minutes will be on Friday, April 3, and Saturday, April 4. Full-day and half-day workshops will be held on Thursday, April 2. *
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PRESENTATION TITLE:
Please enter the title of your session or workshop as you would like it to appear in the Conferene Program: *
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PROGRAM DESCRIPTION
Write a two or three sentence abstract of your presentation as you would like it described in the Conference Program (a more detailed description is required at the end of this proposal form): *
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LANGUAGE FOCUS
Select as many as apply:*
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If you indicated OTHER as the language focus, please indicate that langauge here:
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PRESENTATION LANGUAGE
What language will be used in delivering the presentation?*
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If you selected OTHER, please indicate the language of the session or workshop:
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APPROPRIATE LEVELS
Select one:*
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KEYWORD OR TOPIC
Please select only ONE response for the program index:*
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AUDIO-VISUAL NEEDS
Please indicate what audio-visual equipment you will need. Indicate as many responses as apply.
(Note:
SWCOLT will provide an LCD Projector and
speakers in every room. Presenters are expected to bring their own laptop. There may be a fee to the presenter for internet access; these will be communicated as soon as they are known.)*
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DETIALED SESSION DESCRIPTION
Please write a detailed descrition of your presentation (between 200 and 300 words or so), identifying content, procedures, and materials to be used.*
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If you will be the only presenter of this
workshop or session, please skip the following questions and click
SUBMIT at
the end of this survey. We recommend that you
PRINT a
copy of this survey before you submit it.
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SECOND PRESENTER
First Name:
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SECOND PRESENTER
Middle Name or initial:
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SECOND PRESENTER
Last name:
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SECOND PRESENTER
Institution or company:
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MORE PRESENTERS?
If there are additional presenters, please indicate their name and institution:
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