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CONCURRENT SESSION INFORMATION

Deadline for proposal submission: January 30, 2009

Section A: Personal Information

I. Contact Information:

Name:
A name is required.Minimum number of characters not met.
College/Organization:
Please specify the college name.Minimum number of characters not met.
Address: Please specify the address.Minimum number of characters not met.
Telephone:
Please specify your phone number.Invalid phone number format.
Email Address:
Please specify your email addressInvalid email address format.

II. Brief Biographical Information: (max. length = one paragraph)

  A value is required.

Section B: Application

  • Presentation Title:

    Please specify the presentation titleMinimum number of characters not met.
  • Description
    • Program Book Description:Provide description (30 words max.) of presentation as you would like it to appear in the conference program.
    • Presentation Abstract: Provide a brief description (100 words max.) of your presentation. Please include the following information: goals, rationale, and activities.
  • Requirements for Presentation
    • Room Setup:


    • AV Equipment: List specific equipment needed (LCD, laptop, podium, microphone, etc.)

Section C: Assignment Preference Prioritize your preferences (indicate 1st, 2nd, or 3rd). Indicate “NO” for choices that you can NOT accept. NOTE: Specific day is not guaranteed.

Priority Ranking Day Date Time
Please select an item. Wednesday March 11, 2009 PM
Please select an item. Thursday March 12, 2009 AM
Please select an item. Thursday March 12, 2009 PM


Presenter Name:
Please specify the presenter's name.Minimum number of characters not met.

Co-Presenter Name(s)

1.
2.
3.

Remember that each co-presenter must fill out and submit a separate form.

Please return this form by January 30, 2009.

For questions, contact Vanessa Bass, at (336) 599-1181 Ext. 235 or bassv@piedmontcc.edu.