PRESENTER APPLICATION - ONLINE

Please complete the information included on this form. Information provided in bold categories may be used in the program, conference printed materials and to introduce presenters during educational sessions.

Conference: þ all that apply
ACA Texoma Tour (October)
Southwest Camping Conference (January)
Breakfast Club (February)

Session Title:

Session Length:Indicate time

Please Identify Primary Audience(s): þ all that apply
PROGRAMS
Day Camp
Resident Camp
Out of School Hours
User Groups
Environmental Ed
Family Camp
Other:

SPECIAL INTEREST
Special Populations
Religiously Affiliated
Other:

FUNDING TYPE
Agency/Not-For Profit
Independent/Private
Governmental
Other:

HUMAN DEVELOPMENT
Mgr (0-5yrs.)
Mgr (5yrs+)
Program Staff
Admin Staff
Main/Food Service
Other:

Description - (Limit 30 words to be included in program materials)


Key Message Points - (3 to 5 outcomes, please be specific)
1.
2.
3.
4.
5

Presenter Bio - information used to introduce presenter(s)


Audio-Visual Aids/Room Setup for Conference Please check all supplies that you will need.

þ	Equipment:	All attempts will be made to comply.
	Flip Chart /Easel/Markers
	Overhead Projector/Screen
	LCD/Screen
	Electricity/Power Outlet
	Extension Cords
	Dry Erase Board
	Other:

What type of setting will you prefer at the conference center, for each session?
(classroom setting, no tables in room, etc.)

 Click Send below for consideration:

If you have any questions or concerns, please feel free to contact us at 888-559-CAMP (2267).