2022 Call for Presentations - Western Partnerships Conference on Human Services

Presenter Name*

First Last

Education Credentials (i.e. BCBA, M.Ed., Ph.D., LCSW, JD etc.)

E-Mail*

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Session Title*

This

Session Description (100 words or less)*

Session descriptions should answer the attendees question of "what's in in for me?" Session descriptions must be an accurate account of what will be presented.

List three to five learning objectives*

Attachment: (Resume, Brochure, Full Presentation, etc.)

Max. file size: 50 MB.

Website or YouTube Channel

Presentation Type

Full Day (4.5 hrs)
2 Part Session (3.0 hrs)
1 Session (1.5 hrs)

Level of Presentation

Novice
Intermediate
Veteran
Appropriate for all levels

Is your session geared for beginner, intermediate or an advanced professional?

Intended Audience*

Presenter Biography

Presenter Photograph

Accepted file types: jpg, jpeg, png, gif.

Professional color head shot

Co-Presenter (Please list credentials and bio)

Co-Presenter Photograph

Accepted file types: jpg, jpeg, png, gif.

Reference 1*

First Last

Please provide two references that we may contact about your presentation.

Reference 1 Phone Number*

Reference 1 Email*

Reference 2 Name*

First Last

Reference 2 Phone Number*

Reference 2 Email*

Audio/Visual Needs * Projector and Screen provided. * Wifi available

Flipchart and markers
Podium
Screen
Wireless Microphone
Wired Microphone
Laptop
House Sound (for music/video in your presentation)

Mac users: Please bring all necessary adapters.

Other Needs

Speaker Fee*

Name

This field is for validation purposes and should be left unchanged.