Circles of Life / 2008 Call for Presentations

Call for Presentations - 2008

Online Application Form - due 10/26/07

Proposed Presentation:
Presentation Title: (may be edited for space)
Lead Presenter Contact Information:*
Name
Title
Role: Optional - will be used to determine evidence of partnership if not clear in the workshop description. See Selection Criteria #2	Parent Individual with a disability Professional / Provider / Educator
Organization:
Address:
City, State, Zip:
Phone & Fax:
E-mail:
Web site:
Are you affiliated with one of the COL Conference Co-Sponsors? If yes, indicate which one: See Selection Criteria #10
Will you be the only presenter? If no, please complete associate presenter information below.	Yes No
Summary of the workshop:
This will be used to help the selection committee evaluate your application based on the review criteria. Click here to review the selection criteria. You may wish to copy and paste from a work document.
Workshop Outcomes:
What are the main things participants will take away from this workshop?
Description of Workshop:
This is what will be printed in the program about your workshop. 25 words or less - may be edited for space.
AV Needs: Check all that apply
Flip Chart	Yes No
Overhead	Yes No
TV/VCR	Yes No
Screen	Yes No
LCD Projector	Yes No
Power Strip / Extension Cord	Yes No
Presentation Time Availability:
Thursday 10:45 am - Noon	Yes No
Thursday 1:30 – 2:45 pm	Yes No
Thursday 3:15 – 4:30 pm	Yes No
Friday 8:45 – 10:00 am	Yes No
Friday 10:30 - 11:45 am	Yes No
Presentation Topic Area: Check ALL the apply
Education	Yes No If yes, choose areas below which best describe your workshop's focus Inclusion, IDEA, IEPs, IFSPs, Early Intervention/Birth to Three, B-3 Transition, etc.
Families	Yes No If yes, choose areas below which best describe your workshop's focus Fathers, Siblings, Adoptive/Foster Families, Grandparents, Diversity
Body, Mind and Spirit	Yes No If yes, choose areas below which best describe your workshop's focus Dealing with Stress Spirituality, Grieving Parent Support
Transition to Life after High School /Adult Services & Supports	Yes No If yes, choose areas below which best describe your workshop's focus Employment, Post-Secondary Education, Housing, Independent Living, Self Care, Sexuality
Health Care Issues	Yes No If yes, choose areas below which best describe your workshop's focus Medical home, Family-Centered Care, Mental Health Issues
Services	Yes No If yes, choose areas below which best describe your workshop's focus Long-term care, Medicaid, Private Insurance, Managed Care, Model Programs, Estate Planning, Guardianship
Community	Yes No If yes, choose areas below which best describe your workshop's focus Recreation, Social opportunities, Friendships
Leadership	Yes No If yes, choose areas below which best describe your workshop's focus Parent leadership, Self-determination, Public Policy & Systems Change
Other related topic areas - specify:
Miscellaneous:
Have you given this presentation before?	Yes No
If yes, when and where:
I am interested in receiving information about a presenter stipend. (See number 6 on the instructions and information form)	Yes No
Will you need COL to make copies of your handouts for your presentation? (intended for presenters not affiliated with an organization)	Yes No
Associate Presenter 1 Contact Information: (if no other presenters, skip this section & submit)
Name:
Title:
Role: Optional. See Above	Parent Individual with a disability Professional / Provider / Educator
Organization:
Address:
City, State, Zip:
Phone & Fax:
E-mail:
Web site:
Associate Presenter 2 Contact Information:
Name:
Title:
Role: Optional. See Above	Parent Individual with a disability Professional / Provider / Educator
Organization:
Address:
City, State, Zip:
Phone & Fax:
E-mail:
Web site:

* The lead presenter is the individual will be the primary contact for the workshop.

Return to the CFP home page
Last updated November 27, 2007 by rowley@waisman.wisc.edu