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.
Presenter(s)
Title
Employer
Address
City, St, Zip
Home Phone
xxx-xxx-xxxx
Work Phone
Email
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. 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.) A committee of staff and volunteers will review proposals. Approved presentations will be notified in writing no later than the conference registration deadline. Click Send below for consideration: If you have any questions or concerns, please feel free to contact us at 888-559-CAMP (2267).
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.)
A committee of staff and volunteers will review proposals. Approved presentations will be notified in writing no later than the conference registration deadline. Click Send below for consideration: If you have any questions or concerns, please feel free to contact us at 888-559-CAMP (2267).