Conference Logo

 

*Program Title:
Conference Presenter
*First Name:
*Last Name:
Middle Initial:
Title:
Institution:
Address:
City:
State:
Zip:
Phone Number:
*Email Address:
Experience Level:
Additional Presenters
Name:
Title:
Institution:
Name:
Title:
Institution:
Name:
Title:
Institution:
Program Information
Session Type: Program interest session
Round table session
Pre-Conference Workshop
Target Audience:
(Use shift key to select multiple targets)
Audio/Visual Equipment Needs
Check only the equipment you definitely need and can not provide yourself.
A flip chart or white board and a projection screen will be available in every room
:
:
Other:
Schedule Request
Do you plan to submit more than one program proposal for SEAHO 2009?
Yes
No

If “yes” please rank your preferred order for programs
you would like to present if more than one of your programs is selected.
1st Choice Title Title:
1st Choice Title Presenter:
2nd Choice Title Title:
2nd Choice Title Presenter:
3rd Choice Title Title:
3rd Choice Title Presenter:
Best Seaho:
Would you like to be considered
for the Best of SEAHO
Yes
No
Topic Area:
Learning Objectives
Please identify 3 learning objectives for your program (20 words each)
Learning Objective 1:
Learning Objective 2:
Learning Objective 3:
Please enter a description of the program for the program booklet.
  • Type directly into the text box or cut and paste from a word processing document
  • Must not exceed 100 word

Outline of presentation (500 word maximum)

  • Detailed outline of presentation
  • Presentation method, and how it is connected to your learning objectives.
  • Type directly into the text box or cut and paste from a word processing document
  • Must not exceed 500 words