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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, 3rd, or 4th). 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 (9:00-10:00)
Please select an item. Thursday March 12, 2009 AM (10:30-11:30)
Please select an item. Thursday March 12, 2009 PM (2:00-3:00)


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.